Bupivacaine-Lidocaine-Dexamethasone vs Bupivacaine for Motor Recovery in Distal Radius Surgery .
Comparison between bupivacaine-lidocaine, dexamethasone mixture and bupivacaine alone for motor recovery after axillary brachial plexus block in distal radius surgery: A prospective randomized trial.
PLoS One . 2025 Apr 7;20(4):e0321087.Seventy patients with acute closed distal radius fractures scheduled for open reduction and internal fixation under axillary brachial plexus block were randomized to receive either a mixture of 1.2% lidocaine, 0.2% bupivacaine, and 5 mg dexamethasone (n=35) or 0.5% bupivacaine with saline (n=35). The primary outcome was motor block duration. Secondary outcomes included sensory block duration, time to first pain, pain scores, patient satisfaction, and incidence of rebound pain. Outcomes were assessed over the first 24 hours postoperatively. Overall, the results showed no significant difference in motor or sensory recovery times between groups; however, the LA-mixture group had a significantly lower incidence of rebound pain. This suggests the mixture may reduce rebound pain but does not accelerate motor recovery.
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