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Combination of Dexamethasone and Bupivacaine Versus Bupivacaine Alone in Combined Femoral and Sciatic Nerve Block for Intraoperative and Postoperative Analgesia in Patients Undergoing Lower Limb Vascular Surgeries
In regional anesthesia local anaesthetics alone provide analgesia for not more than 4-8 hours. Increasing the duration of local anaesthetic action is often desirable because it prolongs surgical anaesthesia and analgesia. Different additives have been used to prolong regional blockade. Vasoconstrictors can be used to constrict vessels, thereby reducing vascular absorption of the local anaesthetic. Additives like opioids, clonidine and verapamil were added to local anaesthetics, but the results are either inconclusive or associated with side effects. Steroids when used intrathecally are reported to cause arachnoiditis, but there is no evidence suggesting any neuritis when steroids are used in low concentration in peripheral nerve blocks. Steroids have powerful anti-inflammatory as well as analgesic properties. Perineural injection of steroids is reported to influence postoperative analgesia. They relieve pain by reducing inflammation, and blocking transmission of nociceptive C-fibres and by suppressing ectopic neural discharge. The addition of 5 mg of dexamethasone to 10 ml of 0.5% levobupivacaine in interscalene brachial plexus block showed improvement of postoperative analgesia for arthroscopic shoulder operation without any specific complications. The objective of this study is to compare the effects of combining of dexamethasone and bupivacaine versus bupivacaine alone in combined femoral and sciatic nerve block in patients undergoing lower limb vascular surgeries. The effects will be studied in terms of: * Onset of sensory blockade and motor blockade * Duration of analgesia / first request for analgesic * Duration of motor blockade
Details
| Lead sponsor | Sherif Mohamed Abd el moneim Soaida, MD |
|---|---|
| Phase | Phase 4 |
| Status | COMPLETED |
| Enrolment | 63 |
| Start date | 2013-06 |
| Completion | 2015-01 |
Conditions
- Pain
Interventions
- Perineural Dexamethasone and bupivacaine
- Systemic Dexamethasone plus perineural bupivacaine
- intravenous saline plus perineural bupivacaine
Primary outcomes
- Time of onset of sensory blockade — upto 30 min
from time of performing the nerve block till the occurrence of sensory block - Time of onset of motor blockade — up to 30 min
from time of performing the nerve block till the occurrence of motor block - Duration of analgesia — upto 24 hours
time from onset of analgesia till the first request for an analgesic - Duration of motor blockade — upto 24 hours
time from motor blockade till ability to move the limb