Analgesic Effect of Dexmedetomidine or Magnesium Sulphate Added to Bupivacaine in Interscalene Brachial Plexus Block During Shoulder Arthroscopy | ||||
| The Medical Journal of Cairo University | ||||
| Article 125, Volume 87, September, September 2019, Page 3755-3763 PDF (708.04 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/mjcu.2019.69945 | ||||
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| Authors | ||||
| DOAA A. ELZEFTAWY, M.Sc.; MOHAMAD A. EL-HARTY, M.D.; AHMED S. ELGEBALY, M.D.; MONA B. FAYAD, M.D. | ||||
| The Department of Anesthesiology and Surgical Intensive Care, Faculty of Medicine, Tanta University | ||||
| Abstract | ||||
| Abstract Background: Shoulder surgery is accompanied with sig-nificant post-operative pain. Interscalene block is one of regional techniques which is effective and safe to control this pain. Magnesium Sulphate (MgSO4) & dexmedetomidine as adjuvants to bupivacaine is expected to prolong the block with minimal undesirable systemic effects. Aim of Study: The aim of this work was to evaluate the post-operative analgesic effects of ultrasound guided intersca-lene brachial plexus block in elective shoulder surgeries under general anesthesia using either bupivacaine, bupivacaine-magnesium sulphate or bupivacaine-dexmedetomidine. Material and Methods: This double blind RCT was carried out on 45 patients of both sexes, 18-60y, ASA I or II and scheduled for elective arthroscopic shoulder surgeries under GA. US guided interscalene block with total volume 20ml was done to all patients who randomly allocated into 3 equal groups: Group I (control group): 0.25% bupivacaine 18ml, Group II (Mg group): 0.25% bupivacaine 18ml + 2ml 10% MgSO4 200mg and Group III (Dex group): 0.25% bupivacaine 18ml + 2ml dexmedetomidine (100m g). HR & MAP at baseline, skin incision, 30, 60, 90 & 120min after skin incision and at 2h, 4h, 6h & 8h post-operative, onset & duration of sensory block, (VAS & sedation score) at 2, 4, 6, 8 & 12hrs post-operative, onset of 1st and total dose of meperidine and complications were measured. Results: Our results showed no significant difference as regard to age, sex, ASA, duration & type of surgery, sedation score but there was significant decrease in HR, MAP, VAS, onset of sensory block & 1st analgesic requirements, total dose of rescue analgesic and prolongation in sensory block in Mg group & Dex group as compared to control group & also Dex group was superior to Mg group. Conclusion: Dexmedetomidine 100μg was better than MgSO4 200mg when they added to bupivacaine 0.25% in US guided interscalene brachial plexus block as evidenced by prolongation of sensory block, improved quality of post-operative analgesia, decreased requirements of rescue analge-sics and providing desirable sedation without side effects. | ||||
| Keywords | ||||
| Dexmedetomidine; Magnesium sulphate; Inter-scalene brachial plexus block; Shoulder arthros-copy | ||||
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