Effects of perineural administration of dexmedetomidine in combination with bupivacaine in a femoral-sciatic nerve block

Helal, Safaa M; Eskandr, Ashraf M.; Gaballah, Khaled M; Gaarour, I

doi:10.4103/1658-354x.169469

Cited by 42 publications

(18 citation statements)

References 22 publications

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“…The results of our study are in agreement with Helal [14] and his colleagues, who assessed the effects of perineural administration of dexmedetomidine in combination with bupivacaine in a femoral-sciatic nerve block, and they demonstrated that sensory and motor block onset times were shorter by 20% in dexmedetomidine group than in bupivacaine group. In addition to shorter onset time, sensory and motor blockade durations were longer in group BD (+45% and +40%, respectively) than in group B and duration of analgesia was also become longer in group BD by 75% than in group B.…”

Section: Time Of Measurementsupporting

confidence: 92%

Dexmedetomidine as an adjuvant to bupivacaine on combined posterior lumbar plexus and sciatic nerve blocks, is it effective?

Kamhawy

Ellilly

Yakout

2019

Egyptian Journal of Anaesthesia

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Background: Many drugs were added bupivacaine to extend the total time of analgesia in the postoperative period. Dexmedetomidine was a successful additive in neuraxial block. It provides stable hemodynamics and better and prolonged analgesia after surgery. By this present work, we aim to assess the role of added dexmedetomidine to bupivacaine during combined sciatic and posterior lumbar plexus blocks during femur surgery regarding period of sensory and motor blocks, efficacy of its analgesic effect and incidence of adverse effects. Methods: Our trial was done on 80 patients undergoing femur surgeries. They were all randomly chosen into two groups which have undergone combined sciatic nerve and posterior lumbar plexus blocks as solo anesthetic technique by peripheral nerve blocks. Group I: patients received bupivacaine 0.5% with no additives. Group II: patients received dexmedetomidine 100 µg with bupivacaine 0.5%. Results: Adding dexmedetomidine prolongs total duration of motor and sensory block significantly by more than twofold (p = 0.001) as well as it took shorter time to achieve loss of pinprick sensation and also a shorter time was required to reach modified Bromage scale grade IV. Patients in Group 1 requested analgesia earlier after surgery, as well as they had significantly higher morphine consumption postoperatively compared to those in Group II (p = 0.001). Conclusion: Adding of dexmedetomidine to the local anesthetic lessen the time till the beginning of the block and lengthen its total duration. It also prolongs analgesia postoperatively and has few side effects.

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Section: Time Of Measurementsupporting

confidence: 92%

Dexmedetomidine as an adjuvant to bupivacaine on combined posterior lumbar plexus and sciatic nerve blocks, is it effective?

Kamhawy

Ellilly

Yakout

2019

Egyptian Journal of Anaesthesia

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“…In cases of brachial plexus blockade, the addition of DEX to the local anesthetic provided more rapid onset and longer duration of sensory and motor block with better postoperative analgesia [28]. The same effects were reported when DEX 100 μg was added to bupivacaine during ultrasound-guided combined femoral and sciatic block for below knee surgery [29].…”

Section: Discussionmentioning

confidence: 84%

Effect of Adding Dexmedetomidine to Bupivacaine in Ultrasound Guided Rectus Sheath Block: A Randomized Controlled Double-blinded Study

Salem¹,

Alsamahy²,

Ibrahim³

et al. 2019

TOATJ

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Background: Extended midline laparotomy incision is accompanied by intense pain postoperatively which affects patients’ physiology; therefore, good control of postoperative pain is mandatory to decrease the adverse effects on the body. Ultrasound-guided Bilateral Rectus Sheath Block (BRSB) is one of the options to achieve this goal. Objective: The study aimed to assess the analgesic potency of adding dexmedetomidine to bupivacaine in ultrasound-guided BRSB in cancer patients with a midline laparotomy incision. Methods: Sixty adult cancer patients planned for laparotomies with extended midline incision were included. Ultrasound-guided BRSB was performed immediately after the induction of anesthesia. Patients were classified randomly into two groups; B group, where only bupivacaine was used for BRSB and BD group in whom a mixture of bupivacaine and dexmedetomidine was used. Results: A significant decrease in visual analogue scale scores, total morphine consumption, postoperative nausea and vomiting and postoperative cortisol levels was observed in group BD. Conclusion: Dexmedetomidine as an adjuvant to bupivacaine in US-guided rectus sheath block bilaterally proved to be effective for proper pain management postoperatively in cancer patients after extended midline abdominal incision.

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“…In human studies, a dexmedetomidine-lidocaine mixture has been used to provide Bier's block and was shown to improve the quality of anesthesia, decrease tourniquet pain and reduce postoperative analgesic requirement [20]. Helal et al also demonstrated that the addition of dexmedetomidine to bupivacaine in a combined sciatic-femoral nerve block improved the analgesic effect but found significant bradycardia and hypotension in their patients requiring treatment [21]. Most authors have similarly reported (using 100 µg dexmedetomidine) side effects of dexmedetomidine such as hypertension, hypotension, bradycardia or hyperglycemia [22,23].…”

Section: Discussionmentioning

confidence: 99%

Effect of Dexmedetomidine on Levobupivacaine and Ropivacaine in Fascia Iliaca Block for Trochanteric Fractures Treated by Proximal Femoral Nail – A Randomized Trial

Sriramka

Panigrahi

Acharya

et al. 2019

Cureus

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Background: Fascia iliaca block (FIB) is an established procedure for postoperative pain relief in femur fracture surgeries. Dexmedetomidine was found to be a useful additive to local anesthetics (LA) for peripheral nerve blocks resulting in a prolonged anesthetic effect. We evaluated the impact of the addition of dexmedetomidine to an equal concentration of levobupivacaine and ropivacaine for FIB. Methods: The present study is a double-blind, randomized trial conducted on 60 patients in the age group 18-70 years. The patients were divided into two groups: Group LD received 30 ml of an LA solution (29.5 ml 0.25% levobupivacaine and 0.5 ml dexmedetomidine 50 µg), and group RD received 30 ml of another LA solution (29.5 ml 0.25% ropivacaine and 0.5 ml dexmedetomidine 50 µg). The outcomes observed were the duration of analgesia (DOA) and total analgesic requirement (TAR). Results: The DOA was found to be slightly longer in group LD (955.3 ± 114.5 minutes) than in group RD patients (894.6 ± 91.3) with p = 0.027. The TAR was found to be statistically different though clinically irrelevant (group LD: 112 mg; IQR: 105-122 vs. Group RD: 115 mg; IQR: 104-118, p = 0.034, where IQR stands for interquartile range). There were no signs of neurotoxicity in any of the participating patients. Conclusion: Addition of 50 µg dexmedetomidine to 0.25% levobupivacaine extends DOA slightly as compared to when dexmedetomidine is added to 0.25% ropivacaine. However, TAR remains clinically the same for both cases in fascia iliaca block.

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Effects of perineural administration of dexmedetomidine in combination with bupivacaine in a femoral-sciatic nerve block

Cited by 42 publications

References 22 publications

Dexmedetomidine as an adjuvant to bupivacaine on combined posterior lumbar plexus and sciatic nerve blocks, is it effective?

Dexmedetomidine as an adjuvant to bupivacaine on combined posterior lumbar plexus and sciatic nerve blocks, is it effective?

Effect of Adding Dexmedetomidine to Bupivacaine in Ultrasound Guided Rectus Sheath Block: A Randomized Controlled Double-blinded Study

Effect of Dexmedetomidine on Levobupivacaine and Ropivacaine in Fascia Iliaca Block for Trochanteric Fractures Treated by Proximal Femoral Nail – A Randomized Trial

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