Volume 32, Issue 150 (January & February 2024)                   J Adv Med Biomed Res 2024, 32(150): 67-78 | Back to browse issues page


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Jalili S, Kavandi D, Gheiasi S F. Comparison of the Effect of Adding Magnesium Sulfate and Low-Dose Dexamethasone to Ropivacaine for Supraclavicular Brachial Plexus (Trunks) Nerve Block in Elective Upper Limb Surgeries: A Prospective Triple-Blind Randomized Clinical Trial. J Adv Med Biomed Res 2024; 32 (150) :67-78
URL: http://journal.zums.ac.ir/article-1-7179-en.html
1- Dept. of Anesthesiology, School of Medicine, Ayatollah Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran
2- Dept. of Operating Room and Anesthesiology, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran , fatemeh.gheiasi@gmail.com
Abstract:   (289 Views)

Background and Objective: A supraclavicular brachial plexus block (SCBPB) is a safe alternative to general anesthesia in upper limb surgeries. We compared the effect of adding magnesium sulfate (MS) and low-dose dexamethasone (LDD) to ropivacaine in SCBPB in elective upper limb surgeries. 
Materials & Methods: The ultrasound-guided SCBPB was done on 55 candidates for elective upper extremity surgeries in 3 groups by using 200 mg MS + 24 mL ropivacaine 0.5% (MS Group), 4 mg dexamethasone + 24 mL ropivacaine 0.5% (LDD Group), and 1 mL normal saline + 24 mL ropivacaine 0.5% (NS Group). The sample was investigated for the sensory and motor block onset, motor and sensory block duration, analgesia duration, total opioid consumption, and the Visual Analog Scale (VAS) during sensory return.
Results: The onset of motor and sensory block was faster in the MS group compared to the LDD and NS group (P<0.05). The sensory block duration was longer in the LDD group compared to the MS and NS groups. The duration of motor block and analgesia in the LDD group was significantly longer than the NS group (P<0.05). However, this difference was not significant regarding the MS group (p>0.05). The LDD and MS groups were not different in terms of total opioid consumption and VAS at the time of sensory return. However, both groups had significant differences with the NS group (P<0.05).
Conclusion: The LDD prolonged the motor and sensory block duration and analgesia compared to MS.

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Type of Study: Clinical Trials | Subject: Clinical medicine
Received: 2023/02/6 | Accepted: 2023/12/2 | Published: 2024/01/30

References
1. Yousef MF, Sayed-ahmed AS, Hassan AE, Nasr YM. Effect of adding dexamethasone or magnesium sulphate as an adjuvant to bupivacaine in ultrasound guided supraclavicular brachial plexus block for upper limb surgeries; A comparative study. Zagazig Univ Med J. 2021;27(6):1038-46.
2. Thomas SM, Anjali A, Desai JB, Thakkar S. A comparitive study between magnesium sulphate versus dexamethasone as an adjuvant to bupivacaine in supraclavicular brachial plexus block. Indian J Foren Med Toxicol. 2021;15(3) [DOI:10.37506/ijfmt.v15i3.15937]
3. Mukherjee K, Das A, Basunia SR, et al. Evaluation of magnesium as an adjuvant in ropivacaine-induced supraclavicular brachial plexus block: A prospective, double-blinded randomized controlled study. J Res Pharm Pract 2014;3(4):123-9. [DOI:10.4103/2279-042X.145387] [PMID] [PMCID]
4. Hassan AH, Abdelkareem AM. Comparative study between magnesium sulphate versus dexmedetomedine as additives to levobupivacine in ultra sonographic guided supraclavicular block in patient undergoing forearm surgeries. Egypt J Hosp Med. 2021;83(1):1010-6. [DOI:10.21608/ejhm.2021.160046]
5. Prasad GK, Khanna S, Jaishree SV. Review of adjuvants to local anesthetics in peripheral nerve blocks: Current and future trends. Saudi J Anaesth. 2020;14(1):77 [DOI:10.4103/sja.SJA_423_19] [PMID] [PMCID]
6. Axelsson K, Gupta A. Local anaesthetic adjuvants: neuraxial versus peripheral nerve block. Curr Opin Anesthesiol. 2009;22(5):649-54. [DOI:10.1097/ACO.0b013e32832ee847] [PMID]
7. Brummett CM, Williams BA. Additives to local anesthetics for peripheral nerve blockade. Int Anesthesiol Clin. 2011;49(4):104 [DOI:10.1097/AIA.0b013e31820e4a49] [PMID] [PMCID]
8. Lee IO, Kim WK, Kong MH, et al. No enhancement of sensory and motor blockade by ketamine added to ropivacaine interscalene brachial plexus blockade. Acta anaesthesiol Scand. 2002;46(7):821-6. [DOI:10.1034/j.1399-6576.2002.460711.x] [PMID]
9. Jarbo K, Batra YK, Nidhi M, Panda B. Brachial plexus block with midazolam and bupivacaine improves analgesia. Canad J Anesth. 2005;52(8):822-6. [DOI:10.1007/BF03021776] [PMID]
10. Kathuria S, Gupta S, Dhawan I. Dexmedetomidine as an adjuvant to ropivacaine in supraclavicular brachial plexus block. Saudi J Anaesth. 2015;9(2):148. [DOI:10.4103/1658-354X.152841] [PMID] [PMCID]
11. Persec J, Persec Z, Kopljar M et al. Low-dose dexamethasone with levobupivacaine improves analgesia after supraclavicular brachial plexus blockade. Int Orthop. 2014;38(1):101-5. [DOI:10.1007/s00264-013-2094-z] [PMID] [PMCID]
12. Parrington SJ, O'Donnell D, Chan VW et al. Dexamethasone added to mepivacaine prolongs the duration of analgesia after supraclavicular brachial plexus blockade. Region Anesth Pain Med. 2010;35(5):422-6--6. [DOI:10.1097/AAP.0b013e3181e85eb9] [PMID]
13. Tandoc MN, Fan L, Kolesnikov S, Kruglov A, Nader ND. Adjuvant dexamethasone with bupivacaine prolongs the duration of interscalene block: a prospective randomized trial. J Anesth. 2011;25(5):704-9. [DOI:10.1007/s00540-011-1180-x] [PMID]
14. Desmet M, Braems H, Reynvoet M et al. IV and perineural dexamethasone are equivalent in increasing the analgesic duration of a single-shot interscalene block with ropivacaine for shoulder surgery: a prospective, randomized, placebo-controlled study. Br J Anaesth. 2013;111(3):445-52. [DOI:10.1093/bja/aet109] [PMID]
15. Shrestha B, Maharjan S, Tabedar S. Supraclavicular brachial plexus block with and without dexamethasone-a comparative study. Kathmandu Univ Med J. 2003;1(3):158-60.
16. Venkatraman R, Pushparani A, Karthik K, Nandhini P. Comparison of morphine, dexmedetomidine and dexamethasone as an adjuvant to ropivacaine in ultrasound-guided supraclavicular brachial plexus block for postoperative analgesia-a randomized controlled trial. J Anaesthesiol Clin Pharmacol. 2021;37(1):102-7. [DOI:10.4103/joacp.JOACP_70_19] [PMID] [PMCID]
17. Elyazed MMA, Mogahed MM. Comparison of magnesium sulfate and dexmedetomidine as an adjuvant to 0.5% ropivacaine in infraclavicular brachial plexus block. Anesth Essay Res. 2018;12(1):109. [DOI:10.4103/aer.AER_70_17] [PMID] [PMCID]
18. Telci L, Esen F, Akcora D et al. Evaluation of effects of magnesium sulphate in reducing intraoperative anaesthetic requirements. Br J Anaesth. 2002;89(4):594-8. [DOI:10.1093/bja/aef238] [PMID]
19. Koinig H, Wallner T, Marhofer P, et al. Magnesium sulfate reduces intra-and postoperative analgesic requirements. Anesth Analges. 1998;87(1):206-10 [DOI:10.1213/00000539-199807000-00042] [PMID]
20. Chowdhury MNS. Effects of magnesium sulphate (MgSO4) versus fentanyl as an adjuvant to epidural bupivacaine in lower abdominal surgeries. SAS J Surg. 2021;7(11):658-65. [DOI:10.36347/sasjs.2021.v07i11.006]
21. Pande A, Sen IM, Gupta A, Gupta A, Sharma A. Perineural low dexamethasone dose as adjuvant in supraclavicular brachial plexus block for arteriovenous fistula creation in end stage renal disease: a randomized controlled trial. Brazil J Anesthesiol. 2021:1-7.
22. Patil KN, Deshpande JP, Menghal R, John L. Evaluation of magnesium as an adjuvant in ropivacaine induced interscalene brachial plexus block: A prospective, double-blinded, randomized controlled study. Arch Anesthesiol Crit Care. 2022;8(2):134-8.
23. Kore SS, Ubhe SB, Fasil F. Comparison between dexamethasone and fentanyl as an adjuvant to bupivacaine and lignocaine in supraclavicular brachial plexus block for upper limb surgery. J Pharmacol Pharmacother. 2022;13(1):59-63. [DOI:10.1177/0976500X221085803]
24. Huynh TM, Marret E, Bonnet F. Combination of dexamethasone and local anaesthetic solution in peripheral nerve blocks: a meta-analysis of randomised controlled trials. Europ J Anaesthesiol|. 2015;32(11):751-8. [DOI:10.1097/EJA.0000000000000248]
25. Rai S, Kedareshvara K. To compare efficacy of bupivacaine and bupivacaine with dexamethasone for supraclavicular brachial plexus block in patients undergoing upper-limb surgeries: A one-year randomized controlled trial. Indian J Health Sci Biomed Res. 2018;11(1):65. [DOI:10.4103/kleuhsj.kleuhsj_230_17]

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