Clinical Effect of Dexmedetomidine and Dexamethasone as Adjuvants for Brachial Plexus Block

Zhao-sen FENG; Yu FANG; Ding-qin OU; Yi-han YANG; Zhi-yao WANG; Jie HUANG

doi:10.12259/j.issn.2095-610X.S20211005

Volume 42 Issue 10

Oct. 2021

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Zhao-sen FENG, Yu FANG, Ding-qin OU, Yi-han YANG, Zhi-yao WANG, Jie HUANG. Clinical Effect of Dexmedetomidine and Dexamethasone as Adjuvants for Brachial Plexus Block[J]. Journal of Kunming Medical University, 2021, 42(10): 68-75. doi: 10.12259/j.issn.2095-610X.S20211005

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Zhao-sen FENG, Yu FANG, Ding-qin OU, Yi-han YANG, Zhi-yao WANG, Jie HUANG. Clinical Effect of Dexmedetomidine and Dexamethasone as Adjuvants for Brachial Plexus Block[J]. Journal of Kunming Medical University, 2021, 42(10): 68-75. doi: 10.12259/j.issn.2095-610X.S20211005

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Clinical Effect of Dexmedetomidine and Dexamethasone as Adjuvants for Brachial Plexus Block

doi: 10.12259/j.issn.2095-610X.S20211005

Dept. of Anesthesiology，The First Affiliated Hospital of Kunming Medical University，Kunming Yunnan 650032，China

Received Date: 2021-07-25
Available Online: 2021-10-29
Publish Date: 2021-10-30

Abstract

Abstract

Objective To investigate the effect of adding dexmedetomidine （DEX） or dexamethasone （DXM） on the effect of interscalene brachial plexus block. Methods Fifty patients who underwent ultrasound-guided interscalene brachial plexus block were randomly selected, and randomly divided into 5 groups according to different local anesthetic formulations: R group （control group, 0.5% ropivacaine 20 ml, n = 10）; R + LDEX group （0.5% ropivacaine + 1 μg/kg DEX total 20 mL, n = 10）; R + HDEX group （0.5% ropivacaine + 2 μg/kg DEX total 20 mL, n = 10）; R + LDXM group （0.5% ropivacaine + 4 mg DXM total 20 mL, n = 10）; R + HDXM group （0.5% ropivacaine + 8 mg DXM total 20 ml, n = 10）. Results Compared with other groups, the block onset time ofR + LDEX groupand R + HDEX group was significantly shorter （P < 0.05）. Compared with R group, the block time of other experimental groups significantly prolonged （P < 0.01）. The 12 and 24 h VAS scores and the number of postoperative patient-controlled analgesia in the 4 experimental groups were significantly lower than those in the R group （P < 0.001）. The HR of the patients in the R + HDEX group was reduced after 5 minutes of blockade, and lasted for 30 minutes （P < 0.05）. The SBP, DBP and MAP ofR + LDEX and R + HDEX groups increased by 5, 10, and 15 minutes later after blocked （P < 0.05）. After 5 minutes injection of local anesthetics, patients in the R + LDEX and R + HDEX groups showed a decrease in BIS and continued for 30 minutes （P < 0.05）, the decrease in BIS of R + HDEX group was more obvious than that of R + LDEX group. Conclusions Adding DEX and DXM to local anesthetics can significantly prolong the action time of brachial plexus block. DEX can shorten the onset time ofinterscalene brachial plexus block and cause a transient increase in blood pressure. DEX can produce central sedation in a dose-dependent manner effect.
- Dexmedetomidine,
- Dexamethasone,
- Brachial plexus block

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