Intravenous regional anaesthesia: Lidocaine versus combination of lidocaine and dexamethasone.

Objectives: 1) To determine the efficacy of dexamethasone as an adjuvant to lidocaine for intravenous regional anaesthesia (IVRA). 2) To compare the onset and duration of sensory block, motor block and analgesia when lidocaine is used alone and in combination with dexamethasone for intravenous regional anaesthesia. Study Design & Settings: Prospective, randomized. Material & Methods: 50 patients of ASA status I & II aged 15 to 65 years undergoing ambulatory hand surgery were randomly divided to receive either 40 ml of 0.5% lidocaine (control group) or 40 ml of 0.5% lidocaine & 8mg dexamethasone for IVRA (study group). Onset, duration & recovery time of motor & sensory block were compared. Pain was assessed intraoperatively & postoperatively using Visual Analog Scale Score (VAS). Time to request for first analgesia & total analgesic consumption in 24 hrs were noted. Results: There was no statistically significant difference in the onset and duration of sensory and motor block. The recovery time of sensory & motor block was significantly longer in the study group. The patients in the study group had a significantly longer pain free interval. The total analgesic consumption in the first 24 hrs & the number of patients requiring analgesia was significantly lower in the study group. Conclusions: The addition of 8mg dexamethasone to 0.5% lidocaine for IVRA significantly prolongs the recovery time of sensory & motor block, reduces the analgesic consumption postoperatively for 24 hrs and prolongs the time to request for first analgesic