Dexamethasone as an Adjuvant  to Bupivacaine in Supraclavicular  Brachial Plexus Block in Paediatrics  for Post-operative Analgesia

Ribeiro, Karl Nicholas Sa; Ollapally, Anjali; Misquith, Julie C R

doi:10.7860/jcdr/2016/22089.8957

Cited by 8 publications

(8 citation statements)

References 13 publications

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“…20 Ribeiro et al have found a significant increase in duration of analgesia in dexamethasone group in 0.1 mg/kg dosage as compared to placebo with bupivacaine in upper limb surgeries in pediatric age group, The duration of analgesia in the group BD was 27.1±13.4 hours and was significantly higher as compared to the group B, in which it was 13.9±11.3 hours (p<0.05) receiving dexamethasone (0.1 mg/kg) as an adjunct to bupivacaine 0.125%. 21 Similar result has been shown by Akram et al in finding improved tolerance in hand and forearm surgeries and bet-ter analgesia in group receiving dexamethasone as compared to lignocaine and ketorolac, and the difference being statistically significant. 22 Addition of dexamethasone to ropivacaine in transversus abdominis plane (TAP) blockade has also been found to have prolonged analgesia and reduced analgesic requirement in total abdominal hysterectomy.…”

Section: Perineural Dexamethasonesupporting

confidence: 85%

Role of Dexamethasone in Peri-operative Anesthesia Management: A Review of Literature

Gupta¹

2017

Res Pract Anesthesiol Open J

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Dexamethasone has been used widely in clinical specialties including anesthesia. It is regarded as one of the ideal peri-operative agent being readily available, cheap, anti-inflammatory agent, prevents and treats post-operative nausea and vomiting (PONV), promotes appetite, suppress inflammation, a good analgesic agent both as intravenously or as an adjuvant to peripheral nerve blocks, it provides a sense of well-being and is considered to have a good quality of recovery and early discharge in patients from anesthesia. Controversial role of dexamethasone in causing post-operative surgical site infections have been solved and overall adverse effects of dexamethasone are rare and its benefits out-weighs the risks involved. The author did a literature search in Google Scholar and PubMed databases (latest articles related to the role of dexamethasone in peri-operative period over a period of two years 2015-17). KEY WORDS:Dexamethasone; Peri-operative agent; Anesthesia. KEY MESSAGES:Dexamethasone has a tremendous role in preventing post-operative nausea and vomiting, it has a fair analgesic action if given intravenously, epidurally or perineurally, patients receiving dexamethasone have enhanced recovery profiles after surgery and single dose would usually not increase the risk of surgical site infections. Overall adverse effects of dexamethasone are rare and its benefits out-weighs the risks involved.Dexamethasone has been used widely in clinical specialties including anesthesia. The biological half-life is about 3 hours, although the duration of action may be much longer. Dexamethasone is bound to plasma proteins in much lower-levels than other glucocorticoids. Hepatic metabolism (both glucuronidation and sulfation) occurs to produce inactive metabolites, with 65% of the dose of dexamethasone excreted in the urine within 24 hours, with less than 3% unchanged.

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Section: Perineural Dexamethasonesupporting

confidence: 85%

Role of Dexamethasone in Peri-operative Anesthesia Management: A Review of Literature

Gupta¹

2017

Res Pract Anesthesiol Open J

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“…20 Ribeiro et al have found a significant increase in duration of analgesia in dexamethasone group in 0.1 mg/kg dosage as compared to placebo with bupivacaine in upper limb surgeries in pediatric age group, The duration of analgesia in the group BD was 27.1±13.4 hours and was significantly higher as compared to the group B, in which it was 13.9±11.3 hours (p<0.05) receiving dexamethasone (0.1 mg/kg) as an adjunct to bupivacaine 0.125%. 21 Similar result has been shown by Akram et al in finding improved tolerance in hand and forearm surgeries and better analgesia in group receiving dexamethasone as compared to lignocaine and ketorolac, and the difference being statistically significant.…”

Section: Perineural Dexamethasonesupporting

confidence: 77%

Role of Dexamethasone in Peri-operative Anesthesia Management: A Review of Literature

Gupta¹

2017

Anesthesiol Open J

View full text Add to dashboard Cite

Dexamethasone has been used widely in clinical specialties including anesthesia. It is regarded as one of the ideal peri-operative agent being readily available, cheap, anti-inflammatory agent, prevents and treats post-operative nausea and vomiting (PONV), promotes appetite, suppress inflammation, a good analgesic agent both as intravenously or as an adjuvant to peripheral nerve blocks, it provides a sense of well-being and is considered to have a good quality of recovery and early discharge in patients from anesthesia. Controversial role of dexamethasone in causing post-operative surgical site infections have been solved and overall adverse effects of dexamethasone are rare and its benefits out-weighs the risks involved. The author did a literature search in Google Scholar and PubMed databases (latest articles related to the role of dexamethasone in peri-operative period over a period of two years 2015-17).KEY WORDS: Dexamethasone; Peri-operative agent; Anesthesia. KEY MESSAGES:Dexamethasone has a tremendous role in preventing post-operative nausea and vomiting, it has a fair analgesic action if given intravenously, epidurally or perineurally, patients receiving dexamethasone have enhanced recovery profiles after surgery and single dose would usually not increase the risk of surgical site infections. Overall adverse effects of dexamethasone are rare and its benefits out-weighs the risks involved.

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“…Our results showed a comparable duration of analgesia with buprenorphine and dexamethasone, without significant adverse effects. In a study[ 12 ] involving pediatric population, the duration of postoperative analgesia with dexamethasone was 27.1 ± 13.4 h, which was significantly longer than our values. However, all the surgeries in the study were done under general anesthesia with usual doses of opioids.…”

Section: Discussioncontrasting

confidence: 66%

Comparison of dexamethasone and buprenorphine as adjuvant in ultrasound-guided brachial plexus blocks: A randomized controlled trial

2018

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Introduction:Effective postoperative analgesia is imperative for orthopedic surgeries to enhance recovery and facilitate early ambulation. Various additives have been used as adjuvants with local anesthetics in peripheral nerve blocks to provide postoperative analgesia. The aim of this study is to compare the duration of postoperative analgesia with buprenorphine and dexamethasone when administered as an adjuvant during ultrasound-guided brachial plexus blocks.Methodology:Sixty adult patients undergoing various upper arm surgeries were recruited for the study after acquiring ethics committee clearance. They were randomized into two groups of thirty; Group B was given ultrasound-guided supraclavicular block with 10 ml 2% lignocaine with adrenaline and 15 ml 0.5% bupivacaine and 4 mg dexamethasone as adjuvant. Group B was given the same amount of local anesthetics with 0.3 mg buprenorphine as the adjuvant. The duration of postoperative analgesia and incidence of adverse events if any were noted.Results:Both groups were comparable in demographics, time for onset of sensory, and motor block. The duration of postoperative analgesia was 17.4 ± 3.4 h in the buprenorphine group and 18 ± 3.49 h in the dexamethasone group. None of the patients had significant adverse effects. A single dose of buprenorphine and dexamethasone administered perineurally can provide significant postoperative analgesia for upper limb surgeries.

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Dexamethasone as an Adjuvant to Bupivacaine in Supraclavicular Brachial Plexus Block in Paediatrics for Post-operative Analgesia

Cited by 8 publications

References 13 publications

Role of Dexamethasone in Peri-operative Anesthesia Management: A Review of Literature

Role of Dexamethasone in Peri-operative Anesthesia Management: A Review of Literature

Role of Dexamethasone in Peri-operative Anesthesia Management: A Review of Literature

Comparison of dexamethasone and buprenorphine as adjuvant in ultrasound-guided brachial plexus blocks: A randomized controlled trial

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