Online ISSN: 2515-8260

Ropivacaine and Ropivacaine with Dexamethasone as an adjuvant for postoperative analgesic efficacy in Lumbar Paravertebral block in lower limb surgery: A Randomized Comparative Observational study

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1Dr. Kanika Kamboo, 2Dr. Gaurav Chauhan, 3Dr. Balvir Singh Sekhon, 4Dr. Smriti Anand, 5Dr. Rakesh Sadhu, 6Dr. Aruna Sharma

Abstract

Background: Pain during the postoperative period has an impact on the quality of recovery and the length of hospital stay, which is a point of concern both for the surgeon and patients. Many modalities for reducing postoperative pain have been evaluated, with Lumbar paravertebral Block being associated with reduced postoperative pain, significantly reduced postoperative analgesic requirements. Aim: The primary objective of the present study was to assess the analgesic effectiveness of Lumbar paravertebral block given with Ropivacaine alone and Ropivacaine with Dexamethasone (as adjuvant) for elective lower limb surgery. Material and Methods: This was a single-centre, double blinded, hospital-based comparative observational study conducted among a total of 60 patients undergoing lower limb elective surgery given Lumbar paravertebral block given with Ropivacaine alone (30 patients) and Ropivacaine with Dexamethasone, as adjuvant (30 patients). Evaluation of Postoperative pain, with the first demand of analgesia and total analgesic required, was recorded. Results: There was no statistically significant difference between the two groups regarding the distribution of age, weight, gender or BMI. The mean VAS score at 0,6, 12-, 24-, 36- and 48 hours after surgery among patients given lumbar paravertebral block with Ropivacaine alone was 0, 2.6, 4.1, 3.9 and 4.1, respectively. The mean VAS score at 0, 6, 12-, 24-, 36- and 48 hours after surgery among patients given Lumbar Paravertebral Block with Ropivacaine and Dexamethasone was 0, 1.1, 2.5, 3.4, and 3.6, respectively. The mean duration of the first request for analgesia was 14.6 hours and 19.2 hours among the patients given only Ropivacaine in comparison to those given both Ropivacaine + Dexamethasone (p<0.0001). Conclusion: Lumbar paravertebral nerve block given with both Dexamethasone & Ropivacaine for elective lower limb orthopedic surgery improves postoperative analgesic quality and decreases the requirements of analgesia in comparison to patients given Ropivacaine alone.

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