Comparative study of ropivacaine alone versus ropivacaine with dexamethasone in supraclavicular brachial plexus block

Abstract

INTRODUCTIONPain is an unpleasant effect associated with significant psychological and physiological changes during surgery and post-operative period. Regional anaesthetic techniques have specific advantages either for standalone anaesthesia or as analgesic supplements for intraoperative and postoperative care. Brachial plexus block is often used either as an adjuvant to general anesthesia (GA) or as a sole anesthesia modality. Brachial plexus blockade for ambulatory upper-limb surgery can significantly reduce pain and nausea, allowing for faster discharge. Supraclavicular brachial plexus block is preferred for its rapid onset, reliable anesthesia and as a safe technique for any surgery in the upper extremity that does not involve the shoulder. This is mainly because it is a highly effective analgesia ABSTRACT Background: Brachial plexus block is often used either as an adjuvant to general anesthesia (GA) or as a sole anesthesia modality. Supraclavicular brachial plexus block is preferred for its rapid onset, reliable anesthesia and as a safe technique for any surgery in the upper extremity that does not involve the shoulder. We have attempted to undertake this study to compare the haemodynamic, sensory and motor effects of the anaesthetic effect of Ropivacaine alone and Ropivacaine along with Dexamethasone in Supraclavicular Brachial Block in upper limb surgery. Methods: The total duration of surgery was also comparable in both groups. The onset of the sensory and the motor block in bother the groups were similar to each other with no statistical difference, but there was a very high significance in the duration of both sensory and motor block within both the groups. Results: The total duration of surgery was also comparable in both groups. The onset of the sensory and the motor block in bother the groups were similar to each other with no statistical difference, but there was a very high significance in the duration of both sensory and motor block within both the groups. Conclusions: Dexamethasone added to ropivacaine in supraclavicular brachial block for upper limb surgery significantly shortens the onset time and prolongs the duration of sensory and motor blocks without producing sedation in patients.

Perineural and intravenous dexamethasone and dexmedetomidine: network meta‐analysis of adjunctive effects on supraclavicular brachial plexus block

“…The full‐text manuscripts of the remaining 312 studies were assessed. After including studies from hand searches and revision of search, we identified a total of 100 studies for inclusion in this network meta‐analysis [32–131]. The study flow chart is in online Supporting Information Figure S1.…”

“…The network geometry for our two main outcomes was as follows. Eighty‐five trials with 5134 patients examined sensory block duration [33–39, 41–43, 45, 47, 48, 52, 55–59, 61, 63, 65, 67, 68, 70, 71, 73–111, 113–131] (Fig. 1).…”

“…Consequently, these arms yielded estimates from indirect comparisons only. Ninety‐three trials with 5668 patients examined motor block duration [32–43, 45, 48, 50–63, 65, 67, 68, 70–111, 113–131] (Fig. 2).…”

“…We performed pairwise meta‐analysis of 26 trials comparing sensory block duration [33–39, 41–43, 45, 47, 48, 52, 53, 55, 58, 59, 61, 63, 65, 67, 68, 70, 71] and 31 trials comparing motor block duration [33–39, 41–43, 45, 48, 50–56, 58, 59, 61–63, 65, 67, 68, 70–72] for perineural dexamethasone vs. control arm. This revealed no sub‐group differences by indexing status.…”

“…Thirty-eight articles were peer-reviewed and indexed trials[32, 34, 36-38, 42, 44, 53, 54, 58, 59, 63, 66, 69, 72, 75, 79, 81-84, 94, 96, 99, 102, 105, 107, 109, 110, 113-116, 123, 124, 127-129], while 62 articles were peer-reviewed, nonindexed publications [33, 35, 39-41, 43, 45-52, 55-57, 60-62, 64, 65, 67, 68, 70, 73, 74, 76-78, 80, 83, 85-93, 95, 97, 98, 100, 101, 103, 104, 106, 108, 111, 112, 117-122, 125, , 87, 97, 109, 111, 115, 121] and 32 used ropivacaine[36,38,39,49,52,53,56,60,67,74,75,80,81,84,88,92,95,96,102,105,107,108,110,113,114,119,120,123,[127][128][129][130][131].For the primary outcome, sensory block duration, 20 studies were judged to have a low risk of bias[35, 38, 39, 42, 45, 56, 59, 65, 76, 81, 82, 92-94, 107, 110, 113, 115, …”