Dexamathasone added to levobupivacaine improves postoperative analgesia in ultrasound guided interscalene brachial plexus blockade for arthroscopic shoulder surgery

Youn Jin Kim, Guie Yong Lee, Dong Yeon Kim, Chi Hyo Kim, Hee-Jung Baik, Seok Heo, Youn Jin Kim, Guie Yong Lee, Dong Yeon Kim, Chi Hyo Kim, Hee-Jung Baik, Seok Heo

Abstract

Background: The purpose of this study was to evaluate the effect of the addition of 5 mg dexamethasone to 10 ml of 0.5% levobupivacaine on postoperative analgesic effects of ultrasound guided-interscalene brachial plexus block (ISBPB) in arthroscopic shoulder surgery under general anesthesia.

Methods: In 60 patients scheduled for arthroscopic shoulder surgery that underwent general anesthesia, ISBPB was preoperatively performed with 10 ml of 0.5% levobupivacaine under the guidance of ultrasound and a nerve stimulator. Patients were randomly allocated to receive the same volume of normal saline (Group I), 5 mg of dexamethasone (Group II), or 1 : 400,000 epinephrine (Group III) as an adjuvant to the mixture. A blind observer recorded total analgesic consumption, sleep quality, complication, and patient satisfaction using a verbal numerical rating scale (VNRS) at 0, 1, 6, 12, 24, 48 h after the operation.

Results: All patients had successful ISBPB and excellent analgesic effects less than VNRS 4 up to discharge time. VNRS in Group II at 12 h and 48 h was statistically much lower than in Group I and III. There were no differences in total analgesic consumption, sleep quality, complications, and patient satisfaction.

Conclusions: We conclude that the addition of 5 mg of dexamethasone to 10 ml of 0.5% levobupivacaine in ISBPB showed improvement of postoperative analgesia for arthroscopic shoulder operation without any specific complications.

Keywords: Analgesia; Brachial plexus blocks; Dexamethasone; Levobupivacaine; Ultrasound.

Figures

Fig. 1
Fig. 1
Verbal numerical rating scale (VNRS) according to the time interval after arthroscopic shoulder surgery. Values are expressed as mean ± SD. *P < 0.05 compared with Group I. Group I: 1 ml normal saline as an adjuvant to 10 ml of 0.5% levobupivacaine for interscalene brachial plexus blockade, Group II: 1 ml of 5 mg dexamethasone as an adjuvant to 10 ml of 0.5% levobupivacaine for interscalene brachial plexus blockade, Group III: 1 : 400,000 epinephrine as an adjuvant to 10 ml of 0.5% levobupivacaine for interscalene brachial plexus blockade.

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