Background
Pain is a great problem after surgical trauma. Acute postoperative pain incidence
was reported to be more than 60% and was not adequately controlled. The authors
aimed to investigate the effect of neostigmine versus dexamethasone on the
duration of anesthesia and postoperative analgesia when added to lidocaine in
a Bier block.
Materials and methods
This randomized double-blind controlled study was carried out on 75 patients
scheduled for elective surgeries under intravenous regional anesthesia (Bier
block). They were randomly allocated into three groups: group C (n=25,
received intravenous 3 mg/kg lidocaine 2%), group D (n=25, received
intravenous 3 mg/kg lidocaine 2%+8 mg dexamethasone), and group N (n=25,
received intravenous 3 mg/kg lidocaine 2%+0.5 mg neostigmine). Visual analog
scale (VAS) was used postoperatively to assess pain. Sensory and motor block
characteristics and duration of postoperative analgesia were evaluated.
Results
The pain scores with the postoperative VAS data were statistically significant lower
in the group D patients than those of groups C and N at 90 min, 105 min, and
120 min (P<0.05). Moreover, it was found that no statistically significant differences
of VAS values were recorded among the three studied groups preoperatively and
postoperatively at 15, 30, 45, 60, and 75 min. Duration of the postoperative
analgesia was significantly longer in group D than group C and group N.
Conclusion
The addition of dexamethasone 8 mg to lidocaine 2% (3 mg/kg) during intravenous
regional anesthesia provided better postoperative analgesia. When compared with
the control group or the neostigmine group, dexamethasone increased the duration
of postoperative analgesia.