Synergistic effects of Paracetamol and Dexamethasone with Lidocaine in Intravenous regional anesthesia (IVRA) of upper limbs: A randomized clinical trial

Abstract

Background and aim: Post-operative pain is considered an important complication of Intravenous regional anesthesia (IVRA) which is gaining popularity especially for surgeries on upper limbs. Methods: The present double blind randomized clinical trial was conducted on 60 candidates of upper limb surgeries aged between 20 and 60 years who were of ASA classes 1 or 2. Subjects were randomly assigned to 4 groups: the first group was treated solely with 3 mg/kg of Lidocaine. The second and third groups received the same amount of Lidocaine plus 8 mg of Dexamethasone or 300 mg of Paracetamol respectively and for the fourth group a combination of all medications was used. For all patients, Lidocaine was diluted with normal saline until a total volume of 40 cc was reached. Onset of Sensory and motor nerve blocks, severity of post-operative pain and amount of mepridine consumption in the first 24 h after surgery were assessed. Results: Onset of Sensory and motor nerve block was significantly accelerated in the fourth group (p < 0.01). Post-operative pain and analgesic consumption were significantly reduced in the fourth group when compared with the other groups (p < 0.05). Conclusion: A combination of Paracetamol and Dexamethasone significantly enhances the analgesic effect of Lidocaine in IVRA by accelerating the establishment of both the sensory and motor nerve blocks and prolonging the period of analgesia as well as improving the quality of analgesia and reducing the need for analgesic medications during and after the operation.

Analgesic effect of paracetamol as an adjuvant to lignocaine in upper limb surgeries under intravenous regional anaesthesia (IVRA)

“…Reda K. Abdel-Rahman et al, found no statistical significant difference in onset and recovery of sensory block and motor block between lower in lignocaine with paracetamol group than lignocaine only group [15] . Mehrdad Noroozi et al, staed that the mean duration of sensory block was statistically significant among study goups (P<0.001) [16] . Sen H et al, stated that onset duration of motor block was shorter and recovery duration of motor and sensory block was significantly longer in lidocaine and paracetamol group [17] .…”