Aim: Comparing the effect of adding dexamethasone to lidocaine with lidocaine alone on the quality of intravenous regional anesthesia for upper limb orthopedic surgeries.
Type of study: Randomized controlled clinical trial, double blinded (patient and the resident responsible for data collection were unaware of the type of trial drugs) in two groups, 3rd stage, one centered, recruiting phase completed.
Inclusion criteria: ASA class I-II, 15 to 65 years old, upper limb injuries distal to the elbow.
Exclusion criteria: Muscle-nerve-skin diseases, allergic reactions, general anesthesia requirement due to inadequate regional anesthesia.
Methods: A double tourniquet was fastened over the same arm of the extremity to be operated. An intravenous line on the back of the same hand was used to inject the local anesthetic solution diluted with distilled water to a volume of 40 cc; containing 3 mg/kg lidocaine in control group and 8 mg dexamethasone added to 3 mg/kg lidocaine in the study group. For sedation 2 mg midazolam is injected intravenously. The sensory block along the extension of the radial, ulnar and median nerves was documented. If needed fentanyl was administered maximally 2 times. In the case of inadequate regional block and sedation, general anesthesia was applied and the patient was excluded from the study. Main variables: Sensory block onset, sensory block recovery, time to first request of analgesia in recovery, the amount of opioid usage during operation and patient satisfaction.
Outcomes: Increasing the quality of block.