Beta
234280

Efficacy of Adding Dexamethasone to Levobupivacaine in Erector Spinae Block for Total Hip Arthroplasty

Article

Last updated: 03 Jan 2025

Subjects

-

Tags

-

Abstract

Background: Dexamethasone, when supplemented to a nerve block, promotes its performance while diminishing opioid demands.
Objective: This study was designed to identify the analgesic efficacy of combining dexamethasone with levobupivacaine in the erector spinae block (ESB) for total hip arthroplasty (THA) utilizing ultrasound guidance.
Patients and Methods: 82 patients of both sexes, with ASA physical status I-II, aged from 40 to 70 years were scheduled for a unilateral ESB before general anaesthesia for total hip arthroplasty. They were randomly assigned to two equal groups (n=41each): Levo group: unilateral ESP block was done using 20 mL of 0.5% levobupivacaine only. Dexa group: unilateral ESP block using 19 mL 0.5% levobupivacaine and 1 ml dexamethasone. Preoperative pain was assessed by visual analogue scale (VAS) as well as particular hemodynamics preoperatively and at 0, 2, 4, 8, 12, 16 and 24 hours post-operatively. The total dose of pethidine (mg) given in the first 24-hour was recorded in both groups as the initial analgesic necessity. A list of postoperative complications was kept.
Result: Patients in dexa group demonstrated prolonged postoperative analgesia compared to those in levo group.
In the  first  24 hours, dexa group had a significantly lower postoperative  VAS score, lower  cumulative  pethidine  doses  and  longer  duration until the  first  request  for  analgesia than levo group. The two groups had statistically negligible differences in hemodynamic alterations and the incidence of side effects.
Conclusions:  Using  dexamethasone  as  an  adjuvant  of  ESB  with  Levobupivacaine,  provided  effective  postoperative  analgesia  through  reducing  pain  VAS  score  without  any  reported  hemodynamics  or  postoperative  complications.
 

DOI

10.21608/ejhm.2022.234280

Keywords

dexamethasone, Levobupivacaine, Erector spinae block, Total hip arthroplasty

Authors

First Name

Tamer El-Metwally

Last Name

Farahata

MiddleName

-

Affiliation

-

Email

-

City

-

Orcid

-

First Name

Nahla Salama

Last Name

EL-Bahnasawya

MiddleName

-

Affiliation

-

Email

-

City

-

Orcid

-

First Name

Omnia

Last Name

Heikal

MiddleName

-

Affiliation

Department of Anesthesia, ICU and Pain management Faculty of Medicine, Mansoura University, Egypt

Email

omniaheikal2009@gmail.com

City

-

Orcid

-

First Name

Hesham

Last Name

Abd El-Mohaimena

MiddleName

-

Affiliation

-

Email

-

City

-

Orcid

-

Volume

87

Article Issue

1

Related Issue

31467

Issue Date

2022-04-01

Receive Date

2022-04-29

Publish Date

2022-04-01

Page Start

2,184

Page End

2,189

Print ISSN

1687-2002

Online ISSN

2090-7125

Link

https://ejhm.journals.ekb.eg/article_234280.html

Detail API

https://ejhm.journals.ekb.eg/service?article_code=234280

Order

195

Type

Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

Efficacy of Adding Dexamethasone to Levobupivacaine in Erector Spinae Block for Total Hip Arthroplasty

Details

Type

Article

Created At

22 Jan 2023