ABSTRACT
Background: Application of supraclavicular block mostly includes surgery of elbow, forearm, and hand. The present study wasconducted to evaluate and compare dexamethasone and tramadol as an adjuvant to levobupivacaine in supraclavicular block.Materials and Methods: The present study was conducted on 60 patients of the American Society of Anaesthesiologists Grade Iand II of age group of 18–60 years of either sex. Patients were divided into two groups: Group A (n = 30) in which 30 ml of 0.5%levobupivacaine hydrochloride plus 2 ml tramadol (100 mg) was administered and Group B (n = 30) in which 30 ml of 0.5%levobupivacaine hydrochloride plus 2 ml dexamethasone (8 mg) was administered. Both groups were compared statistically.Results: The mean age ± standard deviation in Group A males was 40.2 ± 12.45 years and in females was 41.3 ± 12.10 yearsand, in Group B, males was 42.1 ± 11.61 years and in females was 41.6 ± 11.33 years. The difference was non-significant(P > 0.05). We found significant difference in onset of sensory block, motor onset, duration of sensory block, motor block,duration of surgery, and duration of analgesia in both the groups (P < 0.05).Conclusion: Dexamethasone is a better adjuvant than tramadol when added to levobupivacaine in supraclavicular brachialplexus block for upper limb surgeries as it is faster in onset and it prolongs the duration of analgesia, sensory, and motorblockade and results in better satisfaction score.
ABSTRACT
Background: Subarachnoid block (SAB) is a widely used regional anesthetic technique for infraumbilical surgeries.Aims: The study was conducted to compare intrathecal nalbuphine with different doses of bupivacaine in infraumbilical surgerieswith respect to hemodynamic changes, side effects, onset and duration of sensory as well as motor blockade, and duration ofanalgesia.Materials and Methods: After obtaining Institutional Ethics Committee approval, a prospective study was conducted on90 patients belonging to American society of Anesthesiology Grades I and II, aged 18–60 years and scheduled for infraumbilicalsurgeries using SAB. Three Groups A, B, and C each with 30 patients were given 0.8 mg nalbuphine along with 10, 12.5, and15 mg of hyperbaric bupivacaine, respectively.Statistical Analysis: Chi-square and unpaired “t” test and following results were observed.Results: Mean onset of sensory block until T10 dermatome was 2.59 ± 0.43, 2.49 ± 0.30, and 2.44–0.33 min while its totalduration was 102.23 ± 5.81, 110.10.83 ± 83, and 136.33 ± 6.15 min in Groups A, B, and C. Maximum motor blockade wasachieved in 7.55 ± 0.57, 7.41 ± 0.51, and 7.30 ± 0.62 min and mean duration of motor block was 145.27 ± 11.80, 155.00 ± 11.58,and 188.00 ± 10.27 min in Groups A, B, and C. Mean time of total duration of the analgesia in Groups A, B, and C was 240.83 ±36.34, 413.77 ± 68.60, and 719.90 ± 99.93 min. Patients in Group C had hypotension at 8th and 10th min intraoperatively whileother parameters and side effects were non-significant.Conclusion: About 0.8 mg of nalbuphine when combined with 12.5 mg of hyperbaric bupivacaine had optimum duration ofanalgesia and sensory block with lesser hemodynamic alterations and side effects.