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  • Comparison of clinical effects of prilocaine, dexamethasone added to prilocaine and levobupivacaine on brachial plexus block.

Comparison of clinical effects of prilocaine, dexamethasone added to prilocaine and levobupivacaine on brachial plexus block.

JPMA. The Journal of the Pakistan Medical Association (2014-05-29)
Aykut Saritas, Cemil Sabuncu
ABSTRACT

To determine whether the addition of 8 mg dexamethasone to axillary brachial plexus block would prolong the duration of sensory and motor block in patients undergoing hand and forearm surgery. The prospective, randomised, double-blinded study was conducted at the Eskisehir Osmangazi University Medical School, Turkey, from October 2008 to December 2009. It comprised 45 American Society of Anaesthesiologists grade I and II patients under elective surgery of the hand and forearm. The patients were randomly divided into 3 groups: 5 mg/kg of 2% prilocaine was applied to Group 1; 5 mg/kg of 2% prilocaine +8mg of dexamethasone (2 ml) was applied to Group 2; and 1.5 mg/kg 0.5% levobupivacaine was applied to Group 3. Sensory and motor block onset time as well as the duration of motor and sensory block of those were monitored and recorded. SPSS 15 was used for statistical analysis. Of the 45 patients, 27 (60%) were men and 18 (40%) were women. There was no significant difference among the groups in terms of demographic data. Based on the duration of motor and sensory block, similar periods of time in Group 1 and Group 2 were noted, whereas this period was statistically different and significantly longer in Group 3 (p < or = 0.001). There were no complications encountered. The addition of dexamethasone to prilocaine prolonged the duration of sensory and motor block. It could be used as an effective adjuvant agent. Levobupivacain could be a more appropriate local anaesthetic in postoperative analgesia and prolonged surgical procedures.

MATERIALS
Product Number
Brand
Product Description

Dexamethasone for peak identification, European Pharmacopoeia (EP) Reference Standard
Supelco
Dexamethasone solution, 1.0 mg/mL in methanol, ampule of 1 mL, certified reference material, Cerilliant®
Dexamethasone, European Pharmacopoeia (EP) Reference Standard
Prilocaine hydrochloride, European Pharmacopoeia (EP) Reference Standard
Supelco
Dexamethasone, Pharmaceutical Secondary Standard; Certified Reference Material
Sigma-Aldrich
Dexamethasone, meets USP testing specifications
Sigma-Aldrich
Dexamethasone, powder, BioReagent, suitable for cell culture, ≥97%
Sigma-Aldrich
Dexamethasone, powder, γ-irradiated, BioXtra, suitable for cell culture, ≥80% (HPLC)
Sigma-Aldrich
Dexamethasone-Water Soluble, BioReagent, suitable for cell culture
Sigma-Aldrich
Prilocaine hydrochloride, ≥98% (TLC)
Sigma-Aldrich
Dexamethasone, ≥98% (HPLC), powder
Supelco
Dexamethasone, VETRANAL®, analytical standard
Sigma-Aldrich
Dexamethasone, tested according to Ph. Eur.
Dexamethasone for system suitability, European Pharmacopoeia (EP) Reference Standard
Bupivacaine hydrochloride, European Pharmacopoeia (EP) Reference Standard