Anaesthesia and Anaesthesiology

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Browsing Anaesthesia and Anaesthesiology by Subject "axillary brachial plexus"

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    Effectiveness of perineural administration of dexamethasone with lidocaine on onset time of sensory block and early post-operative analgesia in axillary block for elective ambulatory forearm, wrist and hand surgery at ALERT hospital, Addis Ababa, 2018, prospective observational study.
    (Addis Ababa Universty, 2018-05) Mola, Simeneh; Girma, Betelihem (BSc, MSc)
    Introduction The axillary brachial plexus block is a popular nerve block for forearm, wrist and hand surgery. Different adjuvant used widely to prolong the duration and fasten the onset of analgesia. Recent evidence demonstrates a potential role of dexamethasone in postoperative pain management, both as a systemic analgesic and as an adjunct to local anesthetics for perineural use. Objective To assess the effectiveness of perineural administration of dexamethasone on lidocaine with adrenaline on onset of sensory block and early post-operative analgesia for trans- arterial axillary block for ambulatory elective forearm, wrist and hand surgery in ALERT hospital, Methodology This prospective cohort study recruits 72 American Society of Anesthesiologist (ASA) class I and II and age between 18-60 years patients by systematic random sampling method. Categorical variable between two groups were analyzed using Chi Square. Distribution numerical data analyzed using Shapiro Wilk test. Mann Whitney U test were used to compare asymmetric numeric data including onset time of sensory block and post-operative pain score. Independent t-test were used to compare mean values of symmetric numeric data including duration of sensory block. Additionally first analgesics request time were analyzed by Kaplan Meier method using log rank test. And p value of <0.05 considered as significant. Results The median onset time of sensory block were comparable between non-exposed group 24(6) and exposed group 24(6) (p=0.068). However, the duration of sensory block significantly longer in exposed group 235.5 ± 37 .51 min than non-exposed group 172.76 ± 28.19 min (p<0.001). The survival time to fist analgesic request were significantly longer in exposed than non-exposed group (p<0.01). Post-operative pain score were significantly lower at 4 and 8 hours in exposed group (p<0.05). Conclusion and recommendations Addition of 8 mg dexamethasone to 1% lidocaine with adrenaline solution in trans-arterial axillary brachial plexus block for ambulatory elective hand, wrist and forearm surgeries prolongs the duration of sensory blockade and analgesic request time but do not reduce the onset of time sensory block. We recommend addition of dexamethasone to 1% lidocaine with adrenaline solution is effective for prolonging duration of sensory block and first analgesics request time.