https://orcid.org/0000-0003-1637-4341
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ABSTRACT
Background
Application of supraclavicular block generally comprises elbow, forearm, and hand surgery. Tramadol and dexamethasone were tested and compared in the current study as adjuvants to levobupivacaine in the supraclavicular block.
Patients and Methods
60 ASA Grade I and II patients of either sex, older than 18, participated in the current study. Two groups of patients were created: Group D (n = 30), who received 30 ml of 0.5% levobupivacaine and 2 ml of dexamethasone (8 mg). 30 ml of 0.5% levobupivacaine and 2 ml of 5% tramadol (100 mg) were given to Group T (n = 30). Statistics were used to compare the two groups.
Results
The tramadol group required substantially less time (13.4 ± 2.6 h) than the dexamethasone group (15.3 ± 2.8 h) for the first rescue analgesia request (P-value = 0.009). Within the first 24 hours following surgery, the mean total dose of rescue analgesia was considerably lower in group D (36 ± 12.2 mg) than in group T (44 ± 15.2 mg, P-value = 0.029). Group D had no side effects and considerably higher patient satisfaction (P = 0.042).
Conclusion
When levobupivacaine was used with dexamethasone in a supraclavicular brachial plexus block for forearm fractures, it worked better as an adjuvant than tramadol. Sensory and motor blockage, a quicker onset and longer duration of analgesia, and higher satisfaction levels were all present.
Acknowledgments
Thank the orthopedic surgery consultants, nurses, residents, and other surgical theatre staff for their contributions.
Disclosure statement
The authors declare that they have no conflicts of interest.
Author contributions
1. Marwa M. Abdelrady: concept, design, literature search, manuscript preparation, editing, review, and final drafting.
2. Wesam Nashat Ali: definition of intellectual content, literature search, and manuscript review.
3. Mohamed Hassan Bakri: clinical studies, editing, and review.
4. Norhan M Bakri: literature search and review.
5. Esraa Gamal Abdel Nasser Fathy: clinical studies, methodological design, and final drafting.
6. Ola Wahba: statistical analysis, editing.
Notes
1 WHAT IS KNOWN? The co-administration of dexamethasone with local anesthetics into the supraclavicular block has decreased postoperative analgesic requirements and has a significant analgesic effect. These advantages of dexamethasone over other adjuvants indicate the need for further studies of the utility of dexamethasone in postoperative analgesia.
WHAT IS NEW? The ultrasound-guided supraclavicular block effectively provides postoperative analgesia in upper limb surgery patients. Using a mixture of local anesthetic and dexamethasone provides better analgesia than tramadol. dexamethasone as an adjuvant to levobupivacaine to perform the ultrasound-guided supraclavicular block was found to be superior in providing longer duration to the first analgesic request, lower analgesic requirement, and lower pain scores.