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1000
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Abstract/Summary
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BACKGROUND: Prolonged motor block, known as “dead arm,” which can cause patient discomfort and anxiety, is a serious concern that is often overlooked in ambulatory surgery, particularly in elderly patients. The purpose of this study was to examine the recovery time of motor blockade with bupivacaine and a mixture of bupivacaine-lidocaine-dexamethasone in axillary brachial plexus block. METHODS: A prospective, randomized, double-blinded controlled trial was conducted with 70 patients scheduled for distal end radius fixation under axillary brachial plexus block. A local anesthetic mixture group (LA-mixture group) received a 21 ml mixture of 0.2% bupivacaine with 1.2% lidocaine and 5 mg of dexamethasone (n = 35). A bupivacaine group received 20 ml of 0.5% bupivacaine with 1 ml of normal saline (n = 35). The primary outcome was the duration of the motor blockade. Secondary outcomes included the duration of sensory blockade, postoperative pain score, and the incidence of rebound pain. RESULTS: The demographic data were similar between the two groups. The mean times for recovery of hand grips and sensation were 13.5 ± 7.3 and 12.6 ± 6.2 hours in the LA-mixture group and 15.3 ± 6.7 and 14.6 ± 6.2 hours in the bupivacaine group. Pain scores were not significantly different between the two groups, but the incidence of rebound pain was lower in the LA-mixture group (8.6% and 28.6%, p = 0.031). CONCLUSION: The bupivacaine-lidocaine, dexamethasone mixture failed to enhance motor recovery compared to 0.5% bupivacaine alone. However, patients in the mixture group appeared to experience a lower incidence of rebound pain.
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