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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Regional Dexamethasone group | Experimental | 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 | Experimental | 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). |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Regional Dexamethasone | Drug | 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). |
| Measure | Description | Time Frame |
|---|---|---|
| Time to the first request of analgesia | Time to the first request of analgesia was recorded from the end of surgery till the first dose of pethidine administrated. | 24 hours postoperatively |
| Measure | Description | Time Frame |
|---|---|---|
| Degree of pain | 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. | 24 hours postoperatively |
| Patient Satisfaction |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Tanta University | Tanta | El-Gharbia | 31527 | Egypt |
The data will be available upon a reasonable request from the corresponding author after the end of study for one year.
After the end of study for one year.
The data will be available upon a reasonable request from the corresponding author.
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| Intravenous Dexamethasone | Drug | 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). |
|
Postoperative Patient Satisfaction measured in " 4 scale patient satisfaction score" ( 1 = highly satisfied , 2 = fairly satisfied , 3 = little satisfied , 4 = non satisfied ). |
| 24 hours postoperatively |
| Total Analgesics consumption | Pethidine 50 mg intravenous was given as postoperative rescue analgesia when the Numeric Rating Scale (NRS) score wasâ„ 4. | 24 hours postoperatively |
| Incidence of complications | Incidence of complications such as nausea, vomiting, hypotension and bradycardia were recorded. | 24 hours postoperatively |