Dexamethasone as an adjuvant to local anesthetic mixture in brachial plexus block: A prospective randomized double-blind controlled trial

Abstract

Introduction: Peripheral neural blockade is now a well-accepted component of comprehensive anesthetic care. Many adjuvants such as dexmedetomidine, clonidine, opioids, ketamine, and midazolam and corticosteroids have been used; however, still the search for ideal adjuvant is in process. The purpose of this study was to investigate whether addition of 8 mg dexamethasone to local anesthetic solution for brachial plexus block would prolong the period of postoperative analgesia. Materials and Methods: This was a prospective double-blind randomized controlled trial. Forty patients between the age of 20 and 65 years, of either sex of the American Society of Anesthesiologists Grade I-III, who were undergoing upper limb surgery, were selected to study the quality of brachial plexus block and duration of postoperative analgesia produced by addition of dexamethasone to local anesthetic solution versus plain local anesthetic solution in the infraclavicular brachial plexus block. Results: Demographic parameters such as age, weight, height, and body mass index were comparable between two groups with P > 0.05. We also observed that onset of sensory and motor block was earlier in Group I, and duration of motor and sensory block was more in Group I. There was a less requirement of postoperative analgesics. Furthermore, the incidence of postoperative complications was less in Group I compared to Group II. Conclusion: We conclude that addition of dexamethasone to local anesthetic solution for brachial plexus block sets the sensory block early, increases the duration of sensory block without any side effect, provides improved patient comfort, effective pain relief, and decreases the requirement of postoperative supplementary analgesic.