الفهرس 
ANATOMY OF THE UPPER LIMBOnly 14 pages are availabe for public view
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Abstract
Intravenous regional anesthesia (IVRA) is a technically simple, reliable and cost-effective method of regional anesthesia for short operative procedures of the extremities. It has disadvantages that include local anesthetic (LA) toxicity, slow onset poor muscle relaxation, tourniquet pain, and the inability to provide prolonged postoperative analgesia.
The ideal IVRA solution should have the following features: rapid onset, reduced dose of LA, and prolonged post deflation analgesia. Different additives such as opioids, non-steroidal anti-inflammatory drugs (NSAIDs), dexmedetomidine, and muscle relaxants have been combined with LAs to improve block quality, prolong post-deflation analgesia.
The purpose of this study was to compare between the effect of adding dexamethasone and paracetamol to IVRA on sensory and motor block onset and recovery times, and postoperative analgesic requirement during upper limb minor surgeries.
Patients were randomly allocated to one of three equal groups. Patients in the paracetamol group (group P) received IVRA using xylocaine 2% in a dose of 3 mg/kg (maximum 200 mg) added to 30 ml Paracetamol (300 mg) reaching 40 ml as a total volume.
Patients in the dexamethasone group (D) received IVRA using xylocaine 2
% in a dose of 3 mg/kg (maximum 200 mg) added to 8 mg dexamethasone diluted with 0.9% saline reaching 40 ml as a total volume.
Patients in the control group (C) received IVRA using xylocaine 2% in a dose of 3 mg/kg diluted with 0.9% normal saline to reach 40ml as a total volume.
As the final results of this study, group (P) and group (C) showed no significant differences regarding the demographic data, blood pressure, heart rate and oxygen saturation, both groups showed delayed sensory and motor onset time, shorter time of sensory, motor block. Both needed an urgent booster dose of opioid as a rescue analgesic dose for controlling pain.
There was no significant difference between group (P), group (C) as regard sensory , motor recovery times , both had a shorter sensory and motor block time need to an opioid dose as an analgesic dose.
group (D) had the fastest sensory and motor block time and more prolonged recovery time than group (P) and group (C) need less opioid dose as analgesia for controlling pain.
As regard postoperative analgesic requirements. group (D) and group (P) needed less analgesic doses than group (C) but there was no significant difference between group (P) and group (C).