International Journal of Medical and Health Research

ISSN: 2454-9142

Vol. 4, Issue 4 (2018)

A randomized clinical study to evaluate effect of dexamethasone with levobupivacaine in sciatic nerve block for post-operative pain relief

Author(s): Dr. Ajay Singh, Dr. Jitendra Agrawal, Dr. R akhi Mittal, Dr. Bhanu Choudhary
Background: Pain is an unavoidable experience in postoperative period. If untreated or undertreated may result in increased morbidity as well as the cost because of impairment of quality of life.
Aims and Objectives: To evaluate postoperative analgesic effect and safety of dexamethasone with levobupivacaine in sciatic nerve block for lower limb orthopedic surgeries.
Materials and Methods: Sixty patients of ASA grade I and II undergoing lower limb orthopaedic surgeries were studied in the Department of Anaesthesiology, GR Medical College and JA Group of Hospitals, Gwalior from December 2015 to August 2017. The patients were divided into Group D (n= 30, were given 24 ml of 0.25% levobupivacaine hydrochloride + 1ml (4mg) of dexamethasone), and Group C (n=30, were given 24ml of 0.25% levobupivacaine hydrochloride + 1ml of normal saline). Postoperative analgesia in terms of VAS score, time to first rescue analgesic (duration of analgesia) and side effect or complication were studied in both the group.
Results: Male preponderance was noted in each group (27 in Group D, and 26 in Group C; p=0.749). Mean age of patients in Group D, and Group C was 34.67±13.55, and 38.93±12.54 years respectively (p>0.05). Mean pulse rate (min), SBP (mmHg), DBP (mmHg) and Sp02 (%) were comparable between groups (P>0.05). MAP (mmHg) was significantly high in Group C compared to Group D. Group D had VAS score of 42.83±0.99 at 12 hours and Group C had 49.46±1.132 at 8 hours (p value < 0.001). At 24 hours VAS score of group D and C were 15.67±1.309 and 15.67±1.714 respectively. One patient each in Group D and C experienced nausea and vomiting and one patient in Group C experienced postoperative shivering.
Conclusion: Dexamethasone is a good alternative for post operative pain management along with Levobupivacaine hydrocholoride compared to Levobupivacaine with minimal postoperative complication.
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