RESUMEN
Background: Brachial plexus blocks are among the most commonly performed peripheral nerve blocks for upper extremity surgeries in clinical practice. Local anesthetics alone for supraclavicular brachial plexus block provide good operative conditions but have shorter duration of postoperative analgesia. Several adjuvants added to local anaesthetics in brachial plexus block are used to achieve quick, dense, and prolonged block. Dexamethasone has been shown to prolong peripheral nerve blockade in animals and, when added to bupivacaine, to extend the duration of analgesia in humans
Objective: The aim of the current study was to evaluate the effects of adding dexamethasone [8 mg] to 28 ml of bupivacaine 0.5% in ultrasound-guided supraclavicular brachial plexus block for upper limb orthopaedic surgery versus bupivacaine 0.5% alone
Patients and Methods: The study included patients scheduled for elective upper limb orthopaedic surgery. A randomized double-blinded controlled study is the design used in this study. It was carried on 40 patients who were divided into two groups; 20 patients of each: group B [control group]: patients received 28 ml of bupivacaine 0.5% + 2 ml of normal saline and group D [study group]: patients received 28 ml of bupivacaine 0.5% + 8 mg of dexamethasone [2 ml]
Results: There was significant difference between both groups as regards the onset of sensory and motor block, group D has faster onset sensory block [10.30 +/- 2.27 versus 12.85 +/- 2.5 minutes, as well as motor block [15.15 +/- 2.37 versus 18.25 +/- 2.22 minutes]. The duration of sensory block was significantly prolonged in group D than in group B [18.45 +/- 2.26 versus 10.33 +/- 1.54 hours] as well as the duration of motor block [14.18 +/- 2.24 versus 8.34 +/- 1.50 hours]. There was significant prolongation of the duration of postoperative analgesia and less doses of postoperative rescue analgesic in group D
Conclusion: We concluded that addition of 8 mg of dexamethasone to bupivacaine 0.5% in ultrasound guided supraclavicular brachial plexus block shortened the onset times of both sensory and motor blocks, significantly prolonged their durations, and prolonged the analgesia of brachial plexus block with subsequent consumption of less amount of postoperative analgesics in comparison to bupivacaine 0.5% alone