Interscalene Brachial Plexus Block With and Without Dexamethasone: A comparative Study

ABSTRACT

Interscalene block is commonly used for anesthesia and analgesia in patients undergoing surgeries of shoulder and upper arm. Combination of lignocaine and bupivacaine is commonly used for this purpose. Addition of dexamethasone to local anesthetic drugs is reported to cause rapid onset and enhance the duration of anesthesia and analgesia. We conducted this study to compare the analgesic effect in interscalene block with local anesthetic versus local anesthetic and steroid. Methods: This was a prospective comparative study conducted in the department of anesthesiology of a tertiary care medical college situated in an urban area. In this study total 120 patients undergoing upper limb surgery under interscalene block were included on the basis of a predefined inclusion and exclusion criteria. Out of these 120 patients 60 patients received lignocaine, adrenaline, bupivacaine and dexamethasone (Group A) whereas remaining 60 patients were given lignocaine, adrenalin, bupivacaine and distilled water (Group B). The comparison of onset of analgesia, onset and duration of motor blockade as well as onset and duration of sensory blockade was compared in both the groups. For statistical analysis SSPE 21.0 software was used and P value less than 0.05 was taken as statistically significant. Results: Majority of the studied cases belonged to the age group of 21-30 years (24.17%) followed by 31-40 years (23.33%). The mean age of patients in both the group was found to be comparable with no statistically significant difference between mean age of both the groups (P>0.05). The mean time for onset of analgesia in Group A and Group B was found to be 7.43 +/- 1.65 and 6.01+/- 1.55. The difference was found to be statistically significant (P<0.0001). The duration of sensory and motor blockade was found to be 14.6+/-12.5 and 11.93+/- 1.48 in group A. where as in group B it was found to be 11.8+/-0.8614 and 8.85 +/- 1.15 respectively. Onset of sensory blockade was found to be 7.01 +/-2.12 and 9.09 +/- 3.08 in group A and group B respectively. The difference was found to be statistically significant for duration of sensory and motor blockade. Onset of motor blockade was found to be comparable in both the groups with no statistically significant difference (P>0.05). Conclusion: Addition of dexamethasone to local anesthetic agent for interscalene block is associated with rapid onset of analgesia and a prolonged duration of motor and sensory blockade.