Clinical Trials Logo

Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT06085417
Other study ID # 03.03.2022/03
Secondary ID
Status Completed
Phase N/A
First received
Last updated
Start date January 2, 2023
Est. completion date July 20, 2023

Study information

Verified date October 2023
Source Yuzuncu Yil University
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The aim of this prospective clinical study is to compare the effectiveness of dexamethasone and magnesium sulfate added as adjuvants to bupivacaine in infraclavicular brachial plexus block used under ultrasound guidance for upper extremity surgeries.


Description:

This study was conducted on 90 patients who underwent upper extremity surgery under infraclavicular brachial plexus block. 90 patients included in the study were randomized into 3 groups of 30 people each by the sealed envelope method. 30 participants were included in Group Bupivacaine, 30 participants were included in Group Bupivacaine + Dexamethasone and 30 participants were included in Group Bupivacaine + Magnesium sulfate. The study was started as double blind. According to the local anesthetic used, patients were group B (30 patients, 20 cc 0.5% bupivacaine + 5 cc 0.9% NaCl), group B+D (30 patients, 20 cc 0.5% bupivacaine + 4 mg dexamethasone + 4 cc 0.9% NaCl), group They were divided into three groups as B+M (30 patients, 20 cc 0.5% bupivacaine + 150 mg magnesium sulfate + 4 cc 0.9% NaCl). Complications of the patients, such as sensory block and motor block onset times, peroperative hemodynamic parameters, need for additional analgesia, postoperative block duration, analgesia duration, opioid and NSAID consumption, nausea and vomiting, were recorded


Recruitment information / eligibility

Status Completed
Enrollment 90
Est. completion date July 20, 2023
Est. primary completion date January 2, 2023
Accepts healthy volunteers Accepts Healthy Volunteers
Gender All
Age group 18 Years to 65 Years
Eligibility Inclusion Criteria: - Participants providing informed written and verbal consent - 18-65 years old - ASA I-II - Cases undergoing elective upper extremity surger Exclusion Criteria: - Cases that do not accept regional anesthesia application - Those who are under 18 years of age and over 65 years of age - ASA III and above - Cases in which the operation was started with infraclavicular block and then transferred to general anesthesia. - Those with liver and kidney dysfunction - Those with diabetes mellitus - Those with drug allergies - Patients with acid-base and electrolyte disorders - Pregnant women - Emergency cases - Those with neuropathic disorders - Those with significant psychiatric and cognitive disorders or substance addiction - Those with a history of clavicle fracture, pneumonectomy, contralateral hemidiaphragmatic paralysis, pneumothorax, phrenic or recurrent laryngeal nerve palsy. - Cases with BMI>30 or BMI<18 - Patients in whom regional anesthesia was contraindicated (sepsis, local infection, coagulopathy, heart disease, hypovolemia) were not included in the study.

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
Bupivacaine + dexamethasone
Vital signs were recorded before the block. Peripheral vascular access was established with a 20-gauge catheter and 0.9% NaCl crystalloid solution infusion was started. For sedation, all patients were routinely administered 1mg midazolam intravenously before the procedure. Patients' ASA score, demographic data (age, height, weight), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), SpO2, sensory and motor block onset times , need for additional sedation, side effects and complications, if any, were recorded. The patients' postoperative sensory block and motor block resolution times, VAS scores at the 0th, 3rd, 6th, 12th and 24th postoperative hours, total opioid and NSAID requirements in the first 24 hours, and analgesia durations were recorded. During the perioperative period, all patients were monitored for side effects such as nausea, vomiting, tinnitus, metallic taste in the mouth, and drug allergy.
Bupivacaine + magnesium sulphate
Vital signs were recorded before the block. Peripheral vascular access was established with a 20-gauge catheter and 0.9% NaCl crystalloid solution infusion was started. For sedation, all patients were routinely administered 1mg midazolam intravenously before the procedure. Patients' ASA score, demographic data (age, height, weight), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), SpO2, sensory and motor block onset times , need for additional sedation, side effects and complications, if any, were recorded. The patients' postoperative sensory block and motor block resolution times, VAS scores at the 0th, 3rd, 6th, 12th and 24th postoperative hours, total opioid and NSAID requirements in the first 24 hours, and analgesia durations were recorded. During the perioperative period, all patients were monitored for side effects such as nausea, vomiting, tinnitus, metallic taste in the mouth, and drug allergy.
bupivacaine
bupivacaine

Locations

Country Name City State
Turkey Haci Yusuf GUNES VAN

Sponsors (1)

Lead Sponsor Collaborator
Yuzuncu Yil University

Country where clinical trial is conducted

Turkey, 

References & Publications (3)

Klaastad O, Sauter AR, Dodgson MS. Brachial plexus block with or without ultrasound guidance. Curr Opin Anaesthesiol. 2009 Oct;22(5):655-60. doi: 10.1097/ACO.0b013e32832eb7d3. — View Citation

Mirza F, Brown AR. Ultrasound-guided regional anesthesia for procedures of the upper extremity. Anesthesiol Res Pract. 2011;2011:579824. doi: 10.1155/2011/579824. Epub 2011 May 30. — View Citation

O'Donnell BD, Ryan H, O'Sullivan O, Iohom G. Ultrasound-guided axillary brachial plexus block with 20 milliliters local anesthetic mixture versus general anesthesia for upper limb trauma surgery: an observer-blinded, prospective, randomized, controlled trial. Anesth Analg. 2009 Jul;109(1):279-83. doi: 10.1213/ane.0b013e3181a3e721. — View Citation

Outcome

Type Measure Description Time frame Safety issue
Primary Motor block onset time Motor block examination was performed with the modified Bromage scale. In the motor block examination, thumb orientation was examined for the median nerve, thumb abduction for the radial nerve, thumb adduction for the ulnar nerve, and elbow flexion for the musculocutaneous nerve. Patients with a modified Bromage scale = 2 on the side where the block was applied were considered to have a successful block and the patient's surgery was initiated. 24 hours
Primary Motor Block Duration Motor block durations were determined according to the Bromage scales at the 1st, 3rd, 6th, 12th and 24th postoperative hours. 24 hours
Primary Sensory block onset time Pinprick sensory test was used in the sensory examination of the patients. Sensory examination was performed using a pinprick test on the first 3 fingers and the dorsal side of the wrist for the radial nerve, the medial side of the 5th finger for the ulnar nerve, the first 3 fingers and the volar side of the wrist for the median nerve, and the lateral region of the forearm for the musculocutaneous nerve.Pinprick sensory test = 1 on the side where the block was applied were considered to have a successful block and the patient's surgery was initiated. 24 hours
Primary Sensory block duration Sensory block durations were determined according to the Pinprick sensory test at the 1st, 3rd, 6th, 12th and 24th postoperative hours. 24 hours
Primary VAS score VAS scores at the 1st, 3rd, 6th, 12th and 24th postoperative hours were evaluated. Dexketoprofen trometamol 50 mg was given intravenously to patients with a postoperative VAS Score of 4 and above. If the VAS Score was 6 or above even though NSAIDs were administered, the patients were given the opioid analgesic tramadol hydrochloride 1 mg/kg intravenously. 24 hours
See also
  Status Clinical Trial Phase
Not yet recruiting NCT05549895 - Effect of Intrathecal Dexamethasone on Intra-operative Hemodynamic in Elderly Patients Undergoing Urologic Endoscopic Surgery Phase 4
Recruiting NCT04025840 - Perioperative Epidural Block and Dexamethasone in Pancreatic Cancer Surgery Phase 4
Completed NCT03688269 - Minimal Effective Concentration (EC90) of Ropivacaine Phase 3
Recruiting NCT03043495 - Dexamethasone Dose in Low Volume Bupivacaine USG Supraclavicular Block Phase 4
Completed NCT05070468 - Effect of Dexamethasone on Labor Induction Phase 3
Completed NCT03874936 - The Effect of Perioperative Dexamethasone Administration on Postoperative Pain in Patients Undergoing Periacetabular Osteotomy. Phase 2/Phase 3
Recruiting NCT06133712 - Dexmedetomidine, Ozone and Dexamethasone Local Injection in Carpal Tunnel Syndrome for Pain Relief N/A
Not yet recruiting NCT06044480 - Effect of Dexamethason on Postimplantation Syndrome After EVAR Phase 4
Recruiting NCT04266977 - Restrictive Use of Dexamethasone in Glioblastoma N/A
Recruiting NCT02112864 - Dexamethasone for Reduction of Post Thoracotomy Pain Syndrome N/A
Not yet recruiting NCT05825378 - The Effect of Intercostal Nerve Block With Dexamethasone and Ropivacaine on Rebound Pain After Thoracoscopic Surgery N/A
Recruiting NCT05731960 - Evaluating the Effect of Intravenous Dexamethasone on the Duration of Spinal Anesthesia After Cesarean Delivery Phase 4
Recruiting NCT04654507 - Efficacy of Corticosteroids in Reducing Renal Scarring in Acute Pyelonephritis in Children Phase 3
Completed NCT03125941 - High vs Low Dose Dexamethasone on Complications in the Immediate Postoperative Phase After Mastectomy Phase 4
Unknown status NCT02178449 - Prolongation of Pain Free Time by the Use of Dexamethasone in Peripheral Nerve Blockade Phase 4
Not yet recruiting NCT04763434 - Dexamethasone and Dexmedetomidine as Adjuvants to Ropivacaine in Ultrasound-guided Multilevel Thoracic Paravertebral Block for Lobectomy: A Prospective, Randomized, Triple-blind Study Phase 4
Completed NCT04767256 - Intravenous Dexamethasone and Dexmedetomidine on the Analgesic Efficacy of Erector Spinae Plane Block N/A
Completed NCT03456752 - Perioperative Dexamethasone on Postoperative Outcome in IBD Phase 2
Withdrawn NCT01277731 - Methylprednisolone Replacement for Dexamethasone-induced Hiccup N/A
Completed NCT04714112 - Low-dose Intravenous Dexamethasone at Different Times as Adjunvants for Brachial Plexus Blocks Phase 4