Dexamethasone or Dexmedetomidine as Local Anesthetic Adjuvants for Ultrasound-guided Axillary Brachial Plexus Blocks with Nerve Stimulation
2
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Background: The purpose of this study was to evaluate the effect of dexamethasone or dexmedetomidine added to ropivacaine on the onset and duration of ultrasound-guided axillary brachial plexus blocks (BPB).Methods: Fifty-one ASA physical status I−II patients with elective forearm and hand surgery under axillary brachial plexus blocks were randomly allocated to receive 20 ml of 0.5% ropivacaine with 2 ml of isotonic saline (C group, n = 17), 20 ml of 0.5% ropivacaine with 2 ml (10 mg) of dexamethasone (D group, n = 17) or 20 ml of 0.5% ropivacaine with 2 ml (100 g) of dexmedetomidine (DM group, n = 17). A nerve stimulation technique with ultrasound was used in all patients. The onset time and duration of sensory blocks were assessed. Results: The duration of the sensory block was extended in group D and group DX compared with group C (P ＜ 0.05), but there was no significant difference between group D and group DX. However, there were no significant differences in onset time in all three groups.Conclusions: Dexamethasone 10 mg and dexmedetomidine 100 g were equally effective in extending the duration of ropivacaine in ultrasound-guided axillary BPB with nerve stimulation. However, neither drug has significantly effects the onset time. (Korean J Pain 2016; 29: 29-33)
Abstract
Background: The purpose of this study was to evaluate the effect of dexamethasone or dexmedetomidine added to ropivacaine on the onset and duration of ultrasound-guided axillary brachial plexus blocks (BPB).Methods: Fifty-one ASA physical status I−II patients with elective forearm and hand surgery under axillary brachial plexus blocks were randomly allocated to receive 20 ml of 0.5% ropivacaine with 2 ml of isotonic saline (C group, n = 17), 20 ml of 0.5% ropivacaine with 2 ml (10 mg) of dexamethasone (D group, n = 17) or 20 ml of 0.5% ropivacaine with 2 ml (100 g) of dexmedetomidine (DM group, n = 17). A nerve stimulation technique with ultrasound was used in all patients. The onset time and duration of sensory blocks were assessed. Results: The duration of the sensory block was extended in group D and group DX compared with group C (P ＜ 0.05), but there was no significant difference between group D and group DX. However, there were no significant differences in onset time in all three groups.Conclusions: Dexamethasone 10 mg and dexmedetomidine 100 g were equally effective in extending the duration of ropivacaine in ultrasound-guided axillary BPB with nerve stimulation. However, neither drug has significantly effects the onset time. (Korean J Pain 2016; 29: 29-33)
참고문헌 (18)
- 송장호, "Comparison of dexmedetomidine and epinephrine as an adjuvant to 1% mepivacaine in brachial plexus block", Korean Journal of Anesthesiology, 66(4), pp.283~289 (2014), 대한마취통증의학회
- Movafegh A, "Dexamethasone added to lidocaine prolongs axillary brachial plexus blockade", Anesth Analg, 102, pp.263~267 (2006)
- 김윤진, "Dexamathasone added to levobupivacaine improves postoperative analgesia in ultrasound guided interscalene brachial plexus blockade for arthroscopic shoulder surgery", Korean Journal of Anesthesiology, 62(2), pp.130~134 (2012), 대한마취통증의학회
- 김원교, "Clinical comparisons of 0.5% and 0.375% levobupivacaine for ultrasound-guided axillary brachial plexus block with nerve stimulation", Korean Journal of Anesthesiology, 62(1), pp.24~29 (2012), 대한마취통증의학회
- Esmaoglu A, "Dexmedetomidine added to levobupivacaine prolongs axillary brachial plexus block", Anesth Analg, 111, pp.1548~1551 (2010)
- Marks R, "Steroid-induced vasoconstriction : glucocorticoid antagonist studies", J Clin Endocrinol Metab, 54, pp.1075~1077 (1982)
- Bastos LF, "Intraneural dexamethasone applied simultaneously to rat sciatic nerve constriction delays the development of hyperalgesia and allodynia", Neurosci Lett, 510, pp.20~23 (2012)
- Johansson A, "Local corticosteroid application blocks transmission in normal nociceptive C-fibres", Acta Anaesthesiol Scand, 34, pp.335~338 (1990)
- Sugita K, "Intrathecal steroid therapy for post-traumatic visual disturbance", Neurochirurgia(Stuttg), 26, pp.112~117 (1983)
- Abram SE, "Analgesic and neurotoxic effects of intrathecal corticosteroids in rats", Anesthesiology, 81, pp.1198~1205 (1994)
- De Oliveira GS Jr, "Perineural dexamethasone to improve postoperative analgesia with peripheral nerve blocks : a meta-analysis of randomized controlled trials", Pain Res Treat, 2014, pp.179029~ (2014)
- Talke P, "Systemically administered alpha2-agonist-induced peripheral vasoconstriction in humans", Anesthesiology, 99, pp.65~70 (2003)
- Guo TZ, "Dexmedetomidine injection into the locus ceruleus produces antinociception", Anesthesiology, 84, pp.873~881 (1996)
- Kanazi GE, "Effect of low-dose dexmedetomidine or clonidine on the characteristics of bupivacaine spinal block", Acta Anaesthesiol Scand, 50, pp.222~227 (2006)
- Memiş D, "Adding dexmedetomidine to lidocaine for intravenous regional anesthesia", Anesth Analg, 98, pp.835~840 (2004)
- Esmaoglu A, "Addition of dexmedetomidine to lidocaine for intravenous regional anaesthesia", Eur J Anaesthesiol, 22, pp.447~451 (2005)
- Brummett CM, "Perineural administration of dexmedetomidine in combination with bupivacaine enhances sensory and motor blockade in sciatic nerve block without inducing neurotoxicity in rat", Anesthesiology, 109, pp.502~511 (2008)
- 김경훈, "Safe Sedation and Hypnosis using Dexmedetomidine for Minimally Invasive Spine Surgery in a Prone Position", The Korean Journal of Pain, 27(4), pp.313~320 (2014), 대한통증학회