Regional and Intravenous Dexamethasone in The Prophylaxis of Rebound Pain After Supraclavicular Block in Upper Limb Surgeries

Not Applicable

Completed

• Conditions: Regional; Intravenous; Dexamethasone; Prophylaxis; Upper Limb Surgeries; Rebound Pain; Supraclavicular Block
• Interventions: Drug: Regional Dexamethasone; Drug: Intravenous Dexamethasone

• Registration Number: NCT07074691
• Lead Sponsor: Tanta University

Brief Summary

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.

Detailed Description

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.

Study Timeline

• Study Start: 2023-03-01
• Primary Completion: 2025-02-01
• Study Completion: 2025-02-01
• Status Verified: 2025-07
• Study First Submitted: 2025-07-10
• Study First Submitted QC: 2025-07-10
• Last Update Submitted: 2025-07-10
• Study First Posted: 2025-07-20
• Last Update Posted: 2025-07-20

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 90

Inclusion Criteria

• Age from 21 to 65 years.
• Both sexes.
• American Society of Anesthesiology (ASA) class I-II.
• Undergoing upper limb surgeries.

Exclusion Criteria

• Patient refusal.
• History of allergy to drugs used.
• ASA class more than II ( III-IV-..).
• Uncooperative patient.
• Patients on chronic pain medications.
• Coagulopathy.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Regional Dexamethasone group	Regional Dexamethasone	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).
Intravenous Dexamethasone group	Intravenous Dexamethasone	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).

Primary Outcome Measures

Name	Time	Method
Time to the first request of analgesia	24 hours postoperatively	Time to the first request of analgesia was recorded from the end of surgery till the first dose of pethidine administrated.

Secondary Outcome Measures

Name	Time	Method
Degree of pain	24 hours postoperatively	All patients were familiarized with the Numeric Rating Scale (NRS) from 0 to 10, with 0 representing no pain and 10 representing maximum intolerable pain. NRS score will be assessed and recorded at 30 minutes, 2, 6, 12, 18, 24 hours postoperatively.
Patient Satisfaction	24 hours postoperatively	Postoperative Patient Satisfaction measured in " 4 scale patient satisfaction score" ( 1 = highly satisfied , 2 = fairly satisfied , 3 = little satisfied , 4 = non satisfied ).
Total Analgesics consumption	24 hours postoperatively	Pethidine 50 mg intravenous was given as postoperative rescue analgesia when the Numeric Rating Scale (NRS) score was≥ 4.
Incidence of complications	24 hours postoperatively	Incidence of complications such as nausea, vomiting, hypotension and bradycardia were recorded.

Trial Locations

Locations (1)

Tanta University; 🇪🇬 Tanta, El-Gharbia, Egypt