To evaluate analgesic efficacy of dexamethasone as an adjuvant to ropivacaine in pectoral nerve block: A prospective randomized control study.

ABSTRACT

Background: Pectoral nerve (Pecs) block is an effective component of multimodal analgesic regimens for breast surgeries. In present study we compared analgesic effect of dexamethasone 8 mg as an adjuvant to 0.25% ropivacaine versus 0.25% ropivacaine alone in pectoral nerve block. Methods: The study was conducted in a randomized manner on 60 female patients of American Society of Anesthesiologists (ASA) Grade I and II, aged between 18 to 65 years, scheduled to undergo modified radical mastectomy under general anesthesia (GA). The patients were randomly allocated into 2 groups of 30 patients each. Group A received ultrasound (US)-guided Pecs block with 30 ml of 0.25% ropivacaine and 10 ml normal saline (total volume 40 ml) and Group B received with 30 ml of 0.25% ropivacaine and 8 mg dexamethasone in and 10 ml normal saline (total volume 40 ml). Post-operatively visual analogue score (VAS), duration of analgesia and total analgesic consumption was noted. Student t-test, Mann Whitney U test and Chi-square test were used for statistical analysis. Results: VAS were persistently low for first 4 hours in group B and for first 9 hours in group A (p value < 0.001 at some intervals). The mean duration of analgesia was prolonged in group B as compared to group A (612.33 ± 41.77 min in Group B and 307.70 ± 22.37min in group A) (p <0.001). Total analgesic consumption in first 24 hours post-operatively was also statistically lower in Group B (97.50± 34.96 mg) as compared to group A (177.50± 36.76) (p<0.001). No patient under study reported any adverse effects. Conclusion: Addition of 8 mg dexamethasone as adjuvant to 0.25% ropivacaine for pectoral nerve block increases the duration of analgesia and significantly reduces the amount of analgesic requirement in first 24 hours postoperatively without any significant adverse effects.