Intravenous Versus Perineural Effect Dexamethasone in Interscalene Nerve Block With Levobupivacaine

Mansoura University

Status: Unknown

Conditions: Shoulder Pain

Treatments: Drug: Intravenous dexamethasone with perineural levobupivacaine; Drug: Perineural dexamethasone in addition to levobupivacaine; Drug: Perineural levobupivacaine

Study type: Interventional

Funder types: Other

Identifiers

NCT04284007

MFM_IRB, MS.18.03.65 -

Details and patient eligibility

About

Interscalene brachial plexus block can be used as an additive to general anaesthesia or as the primary anaesthetic for shoulder surgeries for pain management.

The investigators compared the effect of perineural versus intravenous dexamethasone on the prolongation of the action of levobupivacaine in ultrasound guided interscalene block for shoulder and upper arm surgeries.

Full description

Dexamethasone had been shown to prolong the duration of postoperative analgesia when given as an adjuvant for peripheral nerve blocks.

The investigators compared the effect of perineural versus intravenous dexamethasone on the prolongation of the action of levobupivacaine in ultrasound guided interscalene block for shoulder and upper arm surgeries.

The study hypothesized that adding perineural dexamethasone to levobupivacaine in ultrasound guided interscalene block may be more superior to adding intravenous dexamethasone to levobupivacaine and levobupivacaine alone in shoulder and upper arm surgeries as regard analgesic effect, duration of analgesia and hemodynamic stability.

Enrollment: 90 estimated patients

Sex: All

Ages: 20 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• American Society of Anesthesiologists physical status grade I and grade II.

Exclusion criteria

• Patient refusal.
• Neuromuscular diseases (as myopathies, myasthenia gravies, ......)
• Hematological diseases, bleeding or coagulation abnormality.
• Psychiatric diseases.
• Local skin infection
• Sepsis at site of the block.
• Known intolerance to the study drugs.
• Body Mass Index > 40 Kg/m2
• contralateral phrenic palsy
• pneumothorax
• pneumectomy
• severe COPD

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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90 participants in 3 patient groups

Perineural levobupivacaine with intravenous saline

Active Comparator group

Description:

Patients will receive levobupivacaine plus saline in interscalene brachial plexus block in addition to intravenous saline.

Treatment:

Drug: Perineural levobupivacaine

Perineural dexamethasone in addition to levobupivacaine

Experimental group

Description:

Patients will receive levobupivacaine-dexamethasone in interscalene brachial plexus block plus intravenous saline.

Treatment:

Drug: Perineural dexamethasone in addition to levobupivacaine

Intravenous dexamethasone with perineural levobupivacaine

Experimental group

Description:

Patients will receive levobupivacaine plus saline in interscalene brachial plexus block in addition to intravenous dexamethasone.

Treatment:

Drug: Intravenous dexamethasone with perineural levobupivacaine