English

Abstract

Adjuncts to local anesthetics for brachial plexus block may enhance the quality and duration of analgesia. This study tested the hypothesis that adding dexamethasone significantly prolongs the duration of ropivacaine A prospective, randomized, single blinded study was conducted on 50 ASA I or II patients undergoing upper limb surgeries under supra clavicular brachial plexus block. Patients were randomly divided into 2 groups. Patients in group R (n=25) were administered 30 ml of 0.5% Ropivacaine and 2 ml of normal saline and group RD (n=25) were given 30 ml of 0.5% Ropivacaine and 8 mg (2 ml) Dexamethasone. The onset time and duration of sensory and motor blockade were recorded. Hemodynamic variables (i.e., heart rate, non-invasive blood pressure and oxygen saturation) and rescue analgesic requirements were recorded for 24 hrs. postoperatively. RESULTS: Addition of Dexamethasone as adjunct to Ropivocaine significantly prolonged the duration of sensory block which was 9.44±0.8 hours in group R and 19.52±1.5 hours in group RD, in postoperative period without much change in onset and duration of motor block. CONCLUSION: Addition of dexamethasone to ropivacaine in supraclavicular brachial plexus block significantly prolongs the duration of analgesia and motor block in patients undergoing upper limb surgeries and is a remarkably safe and cost effective method of providing postoperative analgesia. Rescue analgesic requirements were significantly less in group RD compared to group R. confirming the significant prolongation of analgesia during intraoperative and postoperative period. Hemodynamic parameters did not differ between groups in the post-operative period.