Effects of dexamethasone added to levobupivacaine during USG-guided infraclavicular brachial plexus block

Abstract

Objective: The aim of this study was to investigate the effects of dexamethasone added to levobupivacaine on duration of block and level of analgesia during ultrasound guided infraclavicular brachial plexus block. Material and Methods: After obtaining the approval of University Ethics Committee, 40 patients [American Society of Anesthesiologists (ASA) I-II only] aged between 18-65 years who were planned to have upper limb surgery were included in the study between November 1, 2011 and April 04, 2012. Before surgery, all patients were informed about the study, and their informed consents were obtained. The patients were divided randomly into two groups. Group I was given only 0.5% 40 ml levobupivacaine, and Group II was administered 0.5% 40 ml levobupivacaine with 8 mg dexamethasone. Following the block, standard monitoring was performed with electrocardiogram, pulse oximetry, blood pressure, and time to start surgery (minutes) and level analgesia [assessed by visual analogue scale (VAS) and verbal rating scale (VRS), respectively] were recorded on 5, 10, 15, 30, 60, 90 and 120th minutes. Hemodynamic parameters, nausea, vomiting, respiratory depression were recorded peroperatively and postoperatively. Patients were questioned for their onset of pain after surgery on 24th and 48th hours. The results were statistically evaluated using one way ANOVA and Chi-square tests. p<0.05 was considered as significant. Results: Two groups were similar for their demographic characteristics. The time to start surgery was found 38±4.1 minutes in group I, and 28.75±3.19 minutes in group II. There were no differences between the groups for VAS or VRS values. The onset of postoperative pain was 18±3.58 hours in group I, and 31±1.55 hours in group II. As a side effect, nausea, vomiting and respiratory depression were not observed in any of the cases. Conclusion: It has been shown that the infraclavicular brachial plexus block performed with dexamethasone added to levobupivacaine has an earlier time to start surgery, and a longer time of postoperative analgesia.