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Comparing Postoperative Analgesic Effect of Dexmedetomidine or Dexamethasone Added to Lidocaine Through Infraclavicular Block in Forearm Surgery

Yaghoobi, Siamak MD; Shahamat, Hoda MD; Alizadeh, Ali MD; Khezri, Marzieh Beigom MD

doi: 10.1097/AJP.0000000000000736
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Objective: The objective of this study was to compare the analgesic efficacy of dexamethasone versus dexmedetomidine added to lidocaine using infraclavicular block in patients undergoing forearm fracture surgery.

Method: Seventy-five patients aged 20 to 60 years were recruited for a prospective, double-blinded, randomized clinical trial. Ultrasound-guided infraclavicular brachial plexus block was performed in 3 groups by injecting 28 mL lidocaine plus 2 mL distilled water (Lido), 28 mL lidocaine plus 2 mL (8 mg) dexamethasone (Dexa), and 28 mL lidocaine plus 2 mL (1 µg/kg) dexmedetomidine (Dexm). Sensory and motor block onset time and the duration, hemodynamic variables, the time for the first analgesic request, and the total analgesic agents consumed within 6 hours after infraclavicular block were assessed.

Results: Sensory block duration in the Dexm group was significantly greater than in the Lido (P=0.019) and Dexa (P=0.046) groups. The mean motor block duration in the Dexm group showed to be significantly longer than that in the Lido group (P=0.009). Pain intensity within 4 hours after block significantly increased in the Lido group compared with that in the Dexa and Dexm groups (P=0.001). Analgesic consumption during 6 hours after the procedure was higher in the Lido group when compared with the other 2 groups (P=0.001). The Dexm group showed the highest reduction in the mean arterial pressure (P=0.006) and heart rate (P=0.001) among the 3 groups.

Conclusions: There was no significant difference in postoperative pain intensity between the Dexa and Dexm groups, although DEXm demonstrated a longer sensory block duration in comparison with dexamethasone as a lidocaine adjuvant in infraclavicular block.

Department of Anesthesiology, Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran

Registration number: IRCT2016011423473N2.

S.Y.: co-author who suggested the topic and the conceptual framework for this research. H.S.: in charge of data acquisition and drafting the manuscript. A.A.: another co-author who contributed to finalizing the title of the study and also participated in the preparation of final conceptual framework design. M.B.K.: the co-author who actively helped toward the final maturation of the initial idea and the concept of the study, data interpretation, and critically reviewing the manuscript.

Supported in part by Research Centers of Kosar and Velayat Hospital, Qazvin University of Medical Sciences, Qazvin, Iran. The authors declare no conflict of interest.

Reprints: Marzieh Beigom Khezri, MD, Department of Anesthesiology, Faculty of Medicine, Qazvin University of Medical Sciences, Shahid Bahonar Ave., P.O. Box 3419759811, Qazvin, Iran (e-mail: mkhezri@qums.ac.ir).

Received September 2, 2018

Received in revised form May 2, 2019

Accepted May 23, 2019

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