ABSTRACT
BackgroundThere is an increase in use of regional anaesthetic techniques in various surgeries.Steroids have anti inflammatory and analgesic properties. Hence , we decided to study the efficacy ofdexamethasone as an adjuvant to local anaesthetic agents in supraclavicular brachial plexus block vialandmark approach for upper limb orthopaedic surgeries.Materials and MethodsAfter ethical clearance, and informed written consent, this prospective randomised controlled clinical studywas carried out in 50 patients, aged 18-50 years, ASA grade I or II, scheduled for elective or emergencyorthopaedic upper limb surgeries.Patients were randomly divided into two groups,Group A- received Inj. Bupivacaine 0.5% 10 ml, Inj. Lignocaine + Adrenaline (1.5%) 20 ml and Inj..Normal saline (0.9%) 2 mlGroup B- received Inj. Bupivacaine 0.5% 10 ml, Inj. Lignocaine + Adrenaline (1.5%) 20 ml and Inj.Dexamethasone (8 mg) 2 mlAfter confirming complete motor and sensory blockade, surgery was commenced.VAS score was recorded for 18 hours postoperatively where 0 equals no pain and 10 as worst possible pain.Results-● The onset of sensory and motor block was significantly faster in patients who receivedcombination of local anaesthetic and dexamethasone.● The duration of motor and sensory block in dexamethasone group was significantly higher thancontrol group.● There was no significant difference in the hemodynamics found between the two groupsperioperatively.● The duration of post operative analgesia was prolonged in dexamethasone group as compared tocontrol group.● Postoperatively, no complications were observed in any group.ConclusionThe addition of dexamethasone to local anaesthetics in supraclavicular approach of brachial plexus blockproduces adequate anaesthesia with following advantage.• Dexamethasone hastens the time of onset of sensory and motor blockade.• It prolongs the duration of sensory and motor blockade.• It prolongs the duration of postoperative analgesia.• Dexamethasone provides stable haemodynamics without any unwanted side effects in perioperative