The role of Ropivacaine and Dexamethasone on Postoperative Analgesia using Ankle Block for Foot Surgeries

Dr. Shipra Gupta; Dr. Pallav Gupta

Volume : X, Issue : VIII, August - 2020

The role of Ropivacaine and Dexamethasone on Postoperative Analgesia using Ankle Block for Foot Surgeries

Dr. Shipra Gupta, Dr. Pallav Gupta

Abstract :

Background: Regional anaesthesia denotes interruption of pain by physiological blockade along their pathway of transmission. Ankle block can be used for all types of foot surgery and is safe and reliable with high success rate. Aim: This study was conducted to evaluate the role of Ropivacaine and Dexamethasone in providing post operative analgesia using ankle block for foot surgeries in patients receiving general anaesthesia. Study Design: Prospective Randomized controlled clinical trial. Patients and Methods: The study was conducted for a period of 1 year. After obtaining approval from the institutional ethical committee and obtaining written informed consent, 40 patients of American Society of Anaesthesiologists physical Status I and II, of either sex, aged 20 to 60 years, scheduled for elective foot surgery under general anaesthesia were enrolled. General anaesthesia was induced in the usual manner, laryngeal mask airway was inserted in a spontaneously eathing patient, and anaesthesia was maintained using inhalational anaesthetic. Ankle block was performed using 20 ml solution containing 18 ml of Ropivacaine 0.75% plus 2 ml of normal saline in Group I and 20 ml solution containing 18ml of ropivacaine 0.75% plus 2 ml of Dexamethasone(8mg) in Group II. The motor block was evaluated by performing the electric nerve stimulation of both the posterior tibial nerves and the deep peroneal nerves and response noted. The success of block was indicated by the absence of motor response. Surgery was started in 30 mins after the block. After recovery from anaesthesia, visual analog score at 1, 4, 6, 12, and 24 h, the time to the first rescue analgesic, and any side effects were noted. Results: Both the groups were comparable with regards to age, sex, weight, ASA grade, duration of surgery. Pain intensity was significantly lower in dexamethasone group (P < 0.05). The time to first rescue analgesic was increased in dexamethasone group (115 ± 5.2 min vs. 76 ± 6.8 min; P < 0.05). There were no major complications in both groups. Conclusion: The addition of dexamethasone to ropivacaine decreased postoperative pain intensity with minimal postoperative complication.