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

Tanta University

Status: Completed

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

Treatments: Drug: Regional Dexamethasone; Drug: Intravenous Dexamethasone

Study type: Interventional

Funder types: Other

Identifiers

NCT07074691

36264MS507/2/24

Details and patient eligibility

About

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.

Full 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.

Enrollment: 90 patients

Sex: All

Ages: 21 to 65 years old

Volunteers: No Healthy Volunteers

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.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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90 participants in 2 patient groups

Regional Dexamethasone group

Experimental group

Description:

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).

Treatment:

Drug: Regional Dexamethasone

Intravenous Dexamethasone group

Experimental group

Description:

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).

Treatment:

Drug: Intravenous Dexamethasone