A Comparative Evaluation Of Dexamethasone As An Adjunct To Bupivacaine And Levobupivacaine For Supraclavicular Brachial Plexus Block Using Peripheral Nerve Stimulator

ABSTRACT

Background:Dexamethasone appears to be effective in prolonging the duration of analgesia from supraclavicular brachial block using levobupivacaine or Bupivacaine. Long acting local anaesthetic, Bupivacaine is associated with cardiac and central nervous system toxicity which prompted the researchers to develop new local anaesthetic agent with a profile similar to bupivacaine but avoiding the toxic effects. Therefore, the aim of the present study is to test the hypothesis that adding dexamethasone significantly prolongs the duration of analgesia for levobupivacaine and bupivacaine and the magnitude of the effect differs among the two local anaesthetics. Methods: A prospective, randomized study was undertaken at JN Medical College. 120 patients posted for upper limb surgeries under Supraclavicular Brachial Plexus Block were assigned into four groups, each containing 30 patients. Group I received 25 ml Bupivacaine 0.5% and 2ml NS. Group II received 25 ml of Bupivacaine 0.5% and 2ml dexamethasone(8mg) .Group III received 25 ml of Levobupivacaine 0.5% and 2ml NS. Group IV received 25 ml of Levobupivacaine 0.5% and2ml dexamethasone (8mg). Results:Dexamethasone significantly prolonged the duration of analgesia of both levobupivacaine and bupivacaine. Conclusion:Dexamethasone prolongs analgesia in supraclavicular blocks using either levobupivacaine or bupivacaine. Considering the less cardiotoxic profile of levo-bupivacaine it should be preferred over bupivacaine.