Shoulder Pain Clinical Trial
Official title:
The Analgesic Effect of Dexmedetomidine as an Adjunct to Local Anesthetics in Ultrasound-guided Interscalene Approach to Brachial Plexus Block for Shoulder Surgery: A Randomized Controlled Trial
The purpose of this study is to determine whether a small dose of Dexmedetomidine, when given either intravenously or as part of the interscalene nerve block solution, prolongs pain relief following shoulder surgery compared to local anesthetic solution alone.
Unilateral shoulder surgical procedures, including acromioplasty, rotator cuff repair and
Bankart procedure generally allow the patient to go home the same day. However, post-surgical
pain is often severe and it is common to encounter a delay in discharge from the hospital due
to difficulty in pain control.
Single shot interscalene block is used in ambulatory shoulder surgery for its advantages that
included a significant reduction in acute pain and analgesic requirements, prolonged time to
first analgesic request, decreased incidence of nausea, as well as earlier hospital
discharge. Previous studies have attempted to prolong the duration of the analgesia of
interscalene block by administering additional drugs to the local anesthetics but these
studies have had varying degrees of success. Dexmedetomidine has recently been considered as
a potentially useful drug in prolonging nerve block analgesia. Various modes of
administration of Dexmedetomidine have demonstrated a consistent effect on the duration of
analgesia. So far, the systemic infusion of Dex has been shown to prolong both neuraxial and
peripheral nerve blocks. When combined with local anesthetics in intravenous regional
anesthesia 9IVRA), Dex enhanced the duration of analgesia. Furthermore, data from animal
studies strongly support the use of Dex as a safe potent adjunct to local anesthetics capable
of prolonging the duration of analgesia of peripheral nerve blocks.
The use of Dexmedetomidine as an adjunct in interscalene block has not been studied yet. This
trial will study the effects of adding Dexmedetomidine as an adjunct to local anesthetics in
interscalene brachial plexus block.
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