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Comparison of the effect of three different adjuvants on the analgesic duration of single injection interscalene brachial plexus block: a prospective, randomized, triple blinded clinical trial.
Seering, Melinda S; Bayman, Emine O; Wong, Cynthia A; Ranganath, Yatish Siddapura; Marian, Anil A.
Afiliación
  • Seering MS; Department of Anesthesia, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA melinda-seering@uiowa.edu.
  • Bayman EO; Department of Anesthesia, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
  • Wong CA; Department of Anesthesia, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
  • Ranganath YS; Department of Anesthesia, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
  • Marian AA; Department of Anesthesia, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
Reg Anesth Pain Med ; 2019 Jul 14.
Article en En | MEDLINE | ID: mdl-31308262
BACKGROUND AND OBJECTIVES: Use of regional anesthesia can result in faster recovery and better patient satisfaction. Addition of perineural adjuncts to local anesthetics may improve the duration of analgesia, but there is a paucity of data comparing them in a single randomized trial. We compared the effects of three adjuncts clonidine, dexamethasone, and buprenorphine, on the duration of analgesia of interscalene brachial plexus block. METHODS: 160 patients, undergoing elective shoulder surgery, were randomized to four groups to receive an interscalene block with one of the following solutions: ropivacaine alone, ropivacaine with clonidine 75 µg, ropivacaine with dexamethasone 8 mg, or ropivacaine with buprenorphine 300 µg. The primary outcome variable was the duration of analgesia; secondary outcome measures were time to onset of the block, and the duration of sensory and motor blocks. RESULTS: There was no statistically significant difference in the total analgesia time among the four groups; p=0.11. The pairwise comparison in analgesic time and 99% CI were: control versus clonidine (-1.94 hours (-7.33 to 3.12)), control versus dexamethasone (-4.16 hours (-9.50 to 0.58)) and control versus buprenorphine (-1.1 hours (-5.34 to 3.23)). There was no differences in block set-up time, or total sensory and motor block duration among the groups. CONCLUSION: There was no significant improvement in the duration of analgesia with addition of any of the three adjuncts to interscalene blocks. However, there was a larger than expected variability in patient response, hence the study may have been underpowered for the primary outcome.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials Aspecto: Patient_preference Idioma: En Revista: Reg Anesth Pain Med Asunto de la revista: ANESTESIOLOGIA / NEUROLOGIA / PSICOFISIOLOGIA Año: 2019 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials Aspecto: Patient_preference Idioma: En Revista: Reg Anesth Pain Med Asunto de la revista: ANESTESIOLOGIA / NEUROLOGIA / PSICOFISIOLOGIA Año: 2019 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido