A RANDOMIZED DOUBLE-BLIND PLACEBO-CONTROLLED CLINICAL TRIAL TO ASSESS THE EFFICACY OF DEXAMETHASONE TO PROVIDE POSTOPERATIVE ANALGESIA AFTER PARAVERTEBRAL BLOCK IN PATIENTS UNDERGOING ELECTIVE THORACOTOMY

• Published in: Journal of evolution of medical and dental sciences Vol. 2; no. 2; pp. 61 - 67
• Main Authors: Bhattacharjee, Dhurjoti Proad, Piplai, Gautam, Nayak, Sushil, Maity, Arup Ratan, Ghosh, Arindam, Karmakar, Manas, Rudra, Jati Sankar
• Format: Journal Article
• Language: English
• Published: Akshantala Enterprises Private Limited 14.01.2013
• Subjects: Dosage and administration; Methods; Patient outcomes; Postoperative care; Steroids (Drugs); Thoracotomy
• ISSN: 2278-4748; 2278-4802
• DOI: 10.14260/jemds/217

In an attempt to improve the recovery and early rehabilitation after thoracotomy, various methods of pain-relief have been tried to prolong the duration and to improve the quality of postoperative analgesia. Paravertebral block using steroids like dexamethasone, administered as an adjuvant along with local anaesthetic agents, could be of particular interest. METHODS: Fifty patients undergoing elective thoracotomy were randomly assigned to one of the following groups containing twenty five patients each. Group D patients received 8 mg (2 ml) of dexamethasone added to 18 ml of 0.25% levobupivacaine as paravertebral block (total volume 20 ml). Group L patients received 18 ml of 0.25% levobupivacaine and 2 ml of isotonic saline (20 ml in total) as paravertebral block. Analgesic effect was evaluated by measuring pain intensity (VAS score) and duration of analgesia. RESULTS: A longer delay was observed between paravertevral block with study medication and first requirement of supplementary analgesic in group D (602.24 [+ or -] 78.72 minutes) compared to group L (410.48 [+ or -] 56.64 minutes). Total consumption of diclofenac sodium in first 24 hours in postoperative period was significantly less in group D. No significant side effects were noted. CONCLUSION: Dexamethasone, used as adjuncts to levobupivacaine for thoracic paravertebral block in patients undergoing thoracotomy, improve the quality and prolong the duration of post operative analgesia. KEY WORDS: Dexamethasone, Levobupivacaine, Thoracotomy, Paravertebral block.