Comparitive Study between Dexamethasone versus Fentanyl as Adjuvant to Local Anesthesia in Supraclavicular Nerve Block in Upper Limb Surgery
Zakaria Abdelaziz Mostafa, Alfred Maurice Said, Ahmed Abdeldayem Abdelhaq, Mohamed Abdelmaabod Abdelsatar- General Medicine
Abstract
Background
Peripheral nerve block as an anesthetic technique plays an important role in modern regional anesthesia. Upper limb surgeries are mostly performed under peripheral blocks such as the brachial plexus block. Peripheral nerve blocks not only provide intra-operative anesthesia, but also extend analgesia in the post-operative period without major systemic side-effects by minimizing stress response and using minimal anesthetic drugs.
Objective
To evaluate the effects of adding dexamethasone and fentanyl to bupivacaine in ultrasound guided supraclavicular brachial plexus block for upper limb surgery versus bupivacaine alone.
Patients and Methods
After obtaining approval from the medical ethical committee in Al-Matareya Teaching Hospital, this study was conducted in Al-Matareya Teaching Hospital in cooperation with Ain Shams University. It was include patients undergoing elective upper limb surgery. A written informed consent was obtained from every patient after explaining the procedure. A randomized double-blinded controlled study is thought to be the most suitable design to achieve the study objectives.
Results
The present study showed that addition of dexamethasone and fentanyl to bupivacaine in ultrasound-guided supraclavicular nerve block shortened the onset times of both sensory and motor blocks and significantly prolonged their duration compared to bupivacaine olny.
Conclusion
In the current study, the addition of dexamethasone or fentanyl to bupivacaine for supraclavicular brachial plexus block make the onset of sensory & motor block faster and prolongation of motor and sensory block duration and prolongation of duration of analgesia more than using bupivacaine only. But onset of motor and sensory block was shorter in fentanyl group than dexamethasone group and duration of sensory and motor block more in dexamethasone rather than fentanyl.