Atracurium with or without Dexmedetomidine as an Adjuvant to Lignocaine for Intravenous Regional Anesthesia in Upper Limb Surgeries

Background: The use of adjuvants in intravenous regional anesthesia [IVRA] for upper limb surgeries seems to increase efficacy and reduce side effects. Trials are continued to reach the ideal combination. Aim of the work: The study aimed to evaluate the efficacy and safety of IVRA for upper arm surg...

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Autores principales:	Mohamed Arafa, Niazy Abdelmokhles Abdelmotableb, Ayman Saleh Ragab
Formato:	article
Lenguaje:	EN
Publicado:	Al-Azhar University, Faculty of Medicine (Damietta) 2021
Materias:	intravenous regional anesthesia upper arm surgery lignocaine dexmedetomidine atracurium Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/5de182559ff846d69ba9d05ed88b7215
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spelling	oai:doaj.org-article:5de182559ff846d69ba9d05ed88b72152021-12-02T14:10:53ZAtracurium with or without Dexmedetomidine as an Adjuvant to Lignocaine for Intravenous Regional Anesthesia in Upper Limb Surgeries2636-41742682-378010.21608/ijma.2021.142227https://doaj.org/article/5de182559ff846d69ba9d05ed88b72152021-01-01T00:00:00Zhttps://ijma.journals.ekb.eg/article_142227_e151eb8f4a776f5d86170d937ee80631.pdfhttps://doaj.org/toc/2636-4174https://doaj.org/toc/2682-3780Background: The use of adjuvants in intravenous regional anesthesia [IVRA] for upper limb surgeries seems to increase efficacy and reduce side effects. Trials are continued to reach the ideal combination. Aim of the work: The study aimed to evaluate the efficacy and safety of IVRA for upper arm surgery using different adjuvants [atracurium and dexmedetomidine]. Patients and methods: 120 patients scheduled for elective upper limb surgeries were included. Patients were divided randomly into four equal groups. Group I received 40 ml lignocaine 0.5% alone, group II: received 40 ml [lignocaine 0.25% plus dexmedetomidine 50 μg], group III received 40 ml [lignocaine 0.25% plus atracurium 2 mg], and group IV received 40 ml [[lignocaine 0.25% plus dexmedetomidine 50 μg and atracurium 2 mg]. surgery duration, quality of anesthesia, postoperative analgesia, and hemodynamics were monitored. Results:The onset of sensory and motor block was significantly shorter in groups II and IV than in group I or III. Also, both sensory and motor block were significantly shorter in group IV when compared to group II [2.53±0.57, 3.60±0.62 vs. 3.33±0.54 and 5.20±0.84 respectively]. Besides, the pain was significantly lower in groups II and IV than groups I or III after deflation at 5, 15, 30, 60 minutes, and up to 8 hours. The need for postoperative analgesia was significantly higher among groups I and III when compared to groups II and IV [56.7%, 63.3% vs. 30.0% and 20.0%, respectively]. No major adverse events were reported. Conclusion: The use of dexmedetomidine as an adjuvant had a significantly better postoperative analgesia, longer duration of sensory and motor block, and earlier onset of action. In addition, the use of atracurium besides dexmedetomidine improves the quality of IVRA.Mohamed ArafaNiazy Abdelmokhles AbdelmotablebAyman Saleh RagabAl-Azhar University, Faculty of Medicine (Damietta)articleintravenous regional anesthesiaupper arm surgerylignocainedexmedetomidineatracuriumMedicine (General)R5-920ENInternational Journal of Medical Arts, Vol 3, Iss 1, Pp 913-921 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	intravenous regional anesthesia upper arm surgery lignocaine dexmedetomidine atracurium Medicine (General) R5-920
spellingShingle	intravenous regional anesthesia upper arm surgery lignocaine dexmedetomidine atracurium Medicine (General) R5-920 Mohamed Arafa Niazy Abdelmokhles Abdelmotableb Ayman Saleh Ragab Atracurium with or without Dexmedetomidine as an Adjuvant to Lignocaine for Intravenous Regional Anesthesia in Upper Limb Surgeries
description	Background: The use of adjuvants in intravenous regional anesthesia [IVRA] for upper limb surgeries seems to increase efficacy and reduce side effects. Trials are continued to reach the ideal combination. Aim of the work: The study aimed to evaluate the efficacy and safety of IVRA for upper arm surgery using different adjuvants [atracurium and dexmedetomidine]. Patients and methods: 120 patients scheduled for elective upper limb surgeries were included. Patients were divided randomly into four equal groups. Group I received 40 ml lignocaine 0.5% alone, group II: received 40 ml [lignocaine 0.25% plus dexmedetomidine 50 μg], group III received 40 ml [lignocaine 0.25% plus atracurium 2 mg], and group IV received 40 ml [[lignocaine 0.25% plus dexmedetomidine 50 μg and atracurium 2 mg]. surgery duration, quality of anesthesia, postoperative analgesia, and hemodynamics were monitored. Results:The onset of sensory and motor block was significantly shorter in groups II and IV than in group I or III. Also, both sensory and motor block were significantly shorter in group IV when compared to group II [2.53±0.57, 3.60±0.62 vs. 3.33±0.54 and 5.20±0.84 respectively]. Besides, the pain was significantly lower in groups II and IV than groups I or III after deflation at 5, 15, 30, 60 minutes, and up to 8 hours. The need for postoperative analgesia was significantly higher among groups I and III when compared to groups II and IV [56.7%, 63.3% vs. 30.0% and 20.0%, respectively]. No major adverse events were reported. Conclusion: The use of dexmedetomidine as an adjuvant had a significantly better postoperative analgesia, longer duration of sensory and motor block, and earlier onset of action. In addition, the use of atracurium besides dexmedetomidine improves the quality of IVRA.
format	article
author	Mohamed Arafa Niazy Abdelmokhles Abdelmotableb Ayman Saleh Ragab
author_facet	Mohamed Arafa Niazy Abdelmokhles Abdelmotableb Ayman Saleh Ragab
author_sort	Mohamed Arafa
title	Atracurium with or without Dexmedetomidine as an Adjuvant to Lignocaine for Intravenous Regional Anesthesia in Upper Limb Surgeries
title_short	Atracurium with or without Dexmedetomidine as an Adjuvant to Lignocaine for Intravenous Regional Anesthesia in Upper Limb Surgeries
title_full	Atracurium with or without Dexmedetomidine as an Adjuvant to Lignocaine for Intravenous Regional Anesthesia in Upper Limb Surgeries
title_fullStr	Atracurium with or without Dexmedetomidine as an Adjuvant to Lignocaine for Intravenous Regional Anesthesia in Upper Limb Surgeries
title_full_unstemmed	Atracurium with or without Dexmedetomidine as an Adjuvant to Lignocaine for Intravenous Regional Anesthesia in Upper Limb Surgeries
title_sort	atracurium with or without dexmedetomidine as an adjuvant to lignocaine for intravenous regional anesthesia in upper limb surgeries
publisher	Al-Azhar University, Faculty of Medicine (Damietta)
publishDate	2021
url	https://doaj.org/article/5de182559ff846d69ba9d05ed88b7215
work_keys_str_mv	AT mohamedarafa atracuriumwithorwithoutdexmedetomidineasanadjuvanttolignocaineforintravenousregionalanesthesiainupperlimbsurgeries AT niazyabdelmokhlesabdelmotableb atracuriumwithorwithoutdexmedetomidineasanadjuvanttolignocaineforintravenousregionalanesthesiainupperlimbsurgeries AT aymansalehragab atracuriumwithorwithoutdexmedetomidineasanadjuvanttolignocaineforintravenousregionalanesthesiainupperlimbsurgeries
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Atracurium with or without Dexmedetomidine as an Adjuvant to Lignocaine for Intravenous Regional Anesthesia in Upper Limb Surgeries

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