A prospective randomized controlled study comparing the analgesic efficacy of dexamethasone when added to bupivacaine in supraclavicular brachial plexus block for upper limb surgeries

BACKGROUND: Different adjuvants have been used to improve the quality and increase the duration of local anesthetics during various nerve blocks. The current study compared the analgesic efficacy of dexamethasone as an adjuvant to bupivacaine in supraclavicular brachial plexus block. AIMS AND OBJECTIVES: To compare the analgesic efficacy of dexamethasone added to bupivacaine and bupivacaine alone in supraclavicular brachial plexus block for upper limb surgeries on various parameters like onset of sensory and motor blockade and duration of analgesia. MATERIALS AND METHODS: 80 patients undergoing upper limb surgeries under supraclavicular block were grouped into Group D (study group) who received 0.5% bupivacaine (25 ml) and epinephrine 1ml of 1 in 1000 ml + dexamethasone 8 mg (2ml) and Group B (control group) who received 0.5% bupivacaine (25 ml) and epinephrine 1ml of 1 in 1000 + distilled water 2ml.Total volume in both groups were 28ml. RESULTS: Mean onset of sensory block 4.2±0.99, 13.6±6 minutes in group D and group B. Mean onset of motor block 7.5±3.2, 11.5±3.43 minutes in group D and group B. Duration of analgesia 18.97±2.67, 9.10±1.79 hours in group D and group B. The early onset of motor and sensory block and duration of analgesia were statistically significant in group D. The time to reach vas score of 2 and 4 were significantly longer in group D when compared to group B. CONCLUSION: Dexamethasone in the dose of 8mg given as an adjuvant in supraclavicular block, results in early onset of motor and sensory block .The duration of analgesia is also prolonged significantly. This prolonged postoperative pain relief helps in early mobilisation and thereby improving physical and psychological wellbeing of the patient. This dose is optimal in that it does not cause any side effects, at the same time it provides excellent perioperative and postoperative analgesia