A Comparative Study Between Regional and Intravenous Dexamethasone in The Prophylaxis of Rebound Pain After Supraclavicular Block in Upper Limb Surgeries: A Double-Blinded Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 90
- 试验地点
- 1
- 主要终点
- Time to the first request of analgesia
研究概览
简要总结
This study aimed to compare the effect of regional and intravenous Dexamethasone in the prophylaxis of rebound pain after supraclavicular block in upper limb surgeries.
详细描述
Rebound pain is defined as "a transient acute increase in postoperative pain which occurs following resolution of a peripheral nerve block (PNB)" or as a phenomenon where a quantifiable difference is seen in the pain scores when the PNB is working compared to when its effect is resolved.
The supraclavicular block is a regional anesthetic technique used as an alternative or adjunct to general anesthesia or used for postoperative pain control for upper extremity surgeries (mid-humerus through the hand).
Dexamethasone, an adjunct used to prolong the duration of neural blockade when administered regionally or systemically, is thought to reduce pain sensitization by inhibiting sensory transmission of nociceptive C-fibers at the dorsal root ganglion and reducing prostaglandin synthesis, thereby suppressing hyperalgesia.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double (Participant, Outcomes Assessor)
入排标准
- 年龄范围
- 21 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age from 21 to 65 years.
- •Both sexes.
- •American Society of Anesthesiology (ASA) class I-II.
- •Undergoing upper limb surgeries.
排除标准
- •Patient refusal.
- •History of allergy to drugs used.
- •ASA class more than II ( III-IV-..).
- •Uncooperative patient.
- •Patients on chronic pain medications.
- •Coagulopathy.
研究组 & 干预措施
Regional Dexamethasone group
Patients were generally anesthetized, then a supraclavicular block is given (0.5% bupivacaine + dexamethasone 8 mg regionally), total volume = 20 mL (18 mL 0.5% bupivacaine + 2 mL dexamethasone).
干预措施: Regional Dexamethasone (Drug)
Intravenous Dexamethasone group
Patients were generally anesthetized, and then a supraclavicular block was administered (0.5% bupivacaine), with a total volume of 20 mL (18 mL of 0.5% bupivacaine and 2 mL of normal saline).
干预措施: Intravenous Dexamethasone (Drug)
结局指标
主要结局
Time to the first request of analgesia
时间窗: 24 hours postoperatively
Time to the first request of analgesia was recorded from the end of surgery till the first dose of pethidine administrated.
次要结局
- Degree of pain(24 hours postoperatively)
- Patient Satisfaction(24 hours postoperatively)
- Total Analgesics consumption(24 hours postoperatively)
- Incidence of complications(24 hours postoperatively)
研究者
Mohamed Gamal AbdElNaby Ramadan Hamada
Resident of Anesthesiology, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt.
Tanta University