Comparison of Fentanyl and Dexamethasone as an Adjuvant to Bupivacain and Lignocaine in Supraclavicular Brachialplexus Block for Upper Limb Surgeries

Abstract

Background and Aims: The role of fentanyl as an adjuvant to regional blocks to hasten the onset of the local anesthetics or prolong their duration of action is proven. But recently, dexamethasone has been studied as an adjuvant to local anaesthetic in peripheral nerve block. The efficacy of dexamethasone compared to fentanyl as an adjuvant is not kn own. We aimed to compare the efficacy of dexamethasone versus fentanyl as an adjuvant to 0.5% Bupivacain with 2% lignocaine in infraclavicular brachial plexus block for upper limb surgeries. Material And Methods: Sixty American Society of Anaesthesiologists-I and II patients aged 18-65 years scheduled for upper limb surgery were randomized to two groups . Group A (n = 30) received 0.25% Bupivacaine 28 ml+ 2% Lignocaine 10 ml+ Fentanyl 2 ml(100μgm) = total 40 ml & Group B (n = 30) received 0.25 % Bupivacaine 28 ml+ 2% Lignocaine 10 ml+ Dexamethsone 2 ml( 10mg) = total 40 ml . The time to onset and peak effect, duration of the block (sensory and motor) time of first analgesic requirement were recorded. Chi-square and ANOVA test were used for categorical and continuous variables respectively P < 0.05 was considered significant. Results: The duration of sensory and motor block in group A and B were 520 .0± 33 min, 235.2 ± 34.8 min and 710.0 ± 66.4 min and 312.3 ± 40.9 min respectively.There was significant prolongation of sensory and motor block in group B as compared to group A (P < 0.5). Time to first analgesic requirement was significantly more in groups B as compared with group A (P < 0.5). Clinically significant complications were absent. Conclusions: We conclude that dexamethasone is more efficacious than fentanyl as an adjuvant to 0.5% Bupivacain with 2% lignocaine in brachial plexus blocks. JBSA 2016; 29(2): 62-66