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142227

Atracurium with or without Dexmedetomidine as an Adjuvant to Lignocaine for Intravenous Regional Anesthesia in Upper Limb Surgeries

Article

Last updated: 04 Jan 2025

OverviewSimilar Items

Subjects

-

Tags

Surgery

Abstract

Background: The use of adjuvants in intravenous regional anesthesia [IVRA] for upper limb surgeries seems to increase efficacy and reduce side effects. Trials are continued to reach the ideal combination.
Aim of the work: The study aimed to evaluate the efficacy and safety of IVRA for upper arm surgery using different adjuvants [atracurium and dexmedetomidine].
Patients and methods: 120 patients scheduled for elective upper limb surgeries were included. Patients were divided randomly into four equal groups. Group I received 40 ml lignocaine 0.5% alone, group II: received 40 ml [lignocaine 0.25% plus dexmedetomidine 50 μg], group III received 40 ml [lignocaine 0.25% plus atracurium 2 mg], and group IV received 40 ml [[lignocaine 0.25% plus dexmedetomidine 50 μg and atracurium 2 mg]. surgery duration, quality of anesthesia, postoperative analgesia, and hemodynamics were monitored.
Results:The onset of sensory and motor block was significantly shorter in groups II and IV than in group I or III. Also, both sensory and motor block were significantly shorter in group IV when compared to group II [2.53±0.57, 3.60±0.62 vs. 3.33±0.54 and 5.20±0.84 respectively].  Besides, the pain was significantly lower in groups II and IV than groups I or III after deflation at 5, 15, 30, 60 minutes, and up to 8 hours.  The need for postoperative analgesia was significantly higher among groups I and III when compared to groups II and IV [56.7%, 63.3% vs. 30.0% and 20.0%, respectively]. No major adverse events were reported.
Conclusion: The use of dexmedetomidine as an adjuvant had a significantly better postoperative analgesia, longer duration of sensory and motor block, and earlier onset of action. In addition, the use of atracurium besides dexmedetomidine improves the quality of IVRA.

DOI

10.21608/ijma.2021.142227

Keywords

Intravenous regional anesthesia, Upper arm surgery, Lignocaine, Dexmedetomidine, atracurium

Authors

First Name

Mohamed

Last Name

Arafa

MiddleName

-

Affiliation

Department of Anesthesia and Intensive Care, Damietta Faculty of Medicine, Al-Azhar University, Egypt

Email

m.arafa@domazhermedicine.edu.eg

City

Dakahlia

Orcid

-

First Name

Niazy Abdelmokhles

Last Name

Abdelmotableb

MiddleName

-

Affiliation

Department of Anesthesia and Intensive Care, Damietta Faculty of Medicine, Al-Azhar University, Egypt

Email

neazy.icu@domazhermedicine.edu.eg

City

Mansura

Orcid

-

First Name

Ayman Saleh

Last Name

Ragab

MiddleName

-

Affiliation

Department of Anesthesia and Intensive Care, Damietta Faculty of Medicine, Al-Azhar University, Egypt

Email

ayman.saleh@domazhermedicine.edu.eg

City

Dakahlia

Orcid

-

Volume

3

Article Issue

1

Related Issue

21557

Issue Date

2021-01-01

Receive Date

2020-10-30

Publish Date

2021-01-01

Page Start

913

Page End

921

Print ISSN

2636-4174

Online ISSN

2682-3780

Article File

IJMA_Volume 3_Issue 1_Pages 913-921.pdf

PDF . 1.8MB

Link

https://ijma.journals.ekb.eg/article_142227.html

Detail API

https://ijma.journals.ekb.eg/service?article_code=142227

Order

3

Type

Original Article

Type Code

816

Publication Type

Journal

Publication Title

International Journal of Medical Arts

Publication Link

https://ijma.journals.ekb.eg/

MainTitle

Atracurium with or without Dexmedetomidine as an Adjuvant to Lignocaine for Intravenous Regional Anesthesia in Upper Limb Surgeries

Details

Type

Article

Created At

22 Jan 2023