RESUMO
To compare the onset of block, duration of analgesia and complications when dexamethasone is added to local anaesthetic bupivacaine in supraclavicular brachial plexus block for upper limb surgery. Quasi experimental study. This study was conducted at the Department of Anaesthesia, PIMS, Islamabad from July 2007 to June 2008. total sixty patients were included in this study. 30 patients were given supraclavicular block with 0.5% Bupivacaine plus normal saline and put in Group A and remaining 30 were given 0.5% bupivacaine plus dexamethasone and put in Group B. Study inclusion criteria were surgery of upper limb, age of the patient between 20 years to 60 years and anaesthesia physical status [ASA] I, II, III. Variables recorded were onset of sensory and motor block for both groups and duration of sensory and motor block in both groups. Rescue analgesia requirement and complications were also noted in both groups. Demographically both groups were well watched T. test was used to compare the onset of sensory and motor block, duration of sensory and motor block and numerical pain score between the two groups. Chi-squre test was used to compare rescue analgesia required and complications between the two groups. P-value less than 0.05 was considered statistically significant. The onset of motor block was similar in both groups [p-0.82] while onset of sensory block was earlier in dexamethasone group [p-0.014]. The duration of sensory and motor block were significantly longer in dexamethasone group [B] than Bupivacaine group alone [A] [P=<0.001]. Rescue analgesia required by the bupivacaine alone [A] was much earlier than dexamethasone group [B] [P= < 0.001]. No serious complications were noted in both groups. The addition of dexamethasone to bupivacaine 0.5% solution in supraclavicular brachial plexus block prolongs the duration of sensory and motor blockade and provides greater pain relief also it shorten the onset of sensory block but has no effect on onset of motor block