Comparison of the Effects of Dexamethasone and magnesıum Sulphate Used as Adjuvant in Infraclavicular Nerve Block.
Condition: Bupivacaine; Dexamethasone; Magnesıum Sulphate; Adjuvant
Study type: Interventional

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.
    

Detailed 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
    

Intervention name(s): Bupivacaine + dexamethasone; Bupivacaine + magnesium sulphate; bupivacaine
Intervention type(s): Drug; Drug; Drug
Intervention description(s): 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.; 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
Other intervention name(s): Group B+D; Group B+M
Intervention MeSH terms: Dexamethasone; Magnesium Sulfate; Bupivacaine
Allocation: Randomized
Intervention model: Sequential Assignment
Intervention model description: The required asepsis in the area where the block would be applied was provided with 10% poviodine iodine and covered with a sterile drape. The USG probe was placed in the sagittal plane 1 cm below the intersection point between the coracoid process and the clavicle, and after visualizing the lateral, posterior and medial cords around the axillary artery, a peripheral nerve block needle was directed towards the 8 o'clock position relative to the axillary artery, in the same plane as the USG probe. When the expected distal motor response was obtained, the current of the peripheral nerve stimulator was reduced to 0.3 mA to avoid intraneural injection. If the motor response disappeared, local anesthetic was injected slowly. Sensory and motor block onset times, saturation, systolic blood pressure, diastolic blood pressure, mean arterial pressure and heart rate peak values at the 0th, 15th, 30th and 60th minutes after the block were recorded.
Masking: Single (Investigator)
Primary purpose: Treatment
Keywords: Adjuvant; Bupivacaine; Dexamethasone; Infraclavicular brachial plexus nerve block; Magnesıum sulphate