The effects of application of 0.5% levobupivacaine together with 5 mg dexamethasone for infra-clavicular block in surgical treatment of forearm fractures

Abstract

Objective:  We aimed to investigate the effects of adding 5mg dexamethasone to 0.5% levobupivacaine on postoperative analgesia after US-guided infra-clavicular block. Methods: This prospective study was performed at Sehitkamil Goverment Hospital, Gaziantep, Turkey, between september 2012 and february 2013. Ninty patients presented with fracture of forearm bones. Patients were randomly allocated to receive ultrasound guided infraclavicular brachial plexus blockade using levobupivacaine 0.5% in conjunction with or without dexamethasone 5 mg. In Group I (n=45), 0.9% NaCl was added as adjuvant. In Group II (n=45), 5 mg dexamethasone was added to 0.5% levobupivacaine and surgical anesthesia was provided. Postoperative pain control was provided by using morphine with intravenous patient controlled analgesia (IVPCA). one mg bolus dose was administered, continued with limit of 5 mg/hour and 10 min of locking time. Verbal ranting scala (VRS), patient satisfaction score (PSS) and total morphine consumption were controlled for postoperative 48 hours. Results: Sensory block onset time was significatly longer in group I. Sensory block time was longer in group II. PSS was higher in group II, total morphine consumption was found more in group I, VRS was significantly higher in group I. Conclusion: Application of 0.5% levobupivacaine together with 5 mg dexamethasone for infra-clavicular block in surgical treatment of forearm fractures reduces sensory block initiation time, prolongs duration of Sensorial Block and reduces analgesic consumption.

Keywords

• levobupivacaine,Forearm,Fracture,Infraclavicular,Block

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