Abstract
Aim and Objectives: To assess the effect of dexamethasone on onset and duration of anaesthesia as well as duration of analgesia when added to local anaesthetic solution for supraclavicular brachial plexus block. Methods: A randomized comparative study included total 60 patients of either sex, age between 18-70 years belonging to ASA Grade I and II undergoing elective or emergency surgeries of upper limb under supraclavicular brachial plexus block. Patients were randomly divided in group A (40 ml volume of lignocaine 2% with adrenaline (1:200000) + 0.5% bupivacaine) and group B (40 ml volume of lignocaine 2% with adrenaline (1:200000) + 0.5% bupivacaine with dexamethasone 8 mg). The onset and duration of sensory and motor block as well as duration of analgesia in the two groups were compared and any complications of the procedure were noted. Result: Group B had early onset and prolonged duration of sensory and motor block as well as prolonged duration of analgesia as compared to group A. None of the patients had bradycardia, hypotension or any other side effects. Conclusion: We concluded that addition of 8 mg dexamethasone to local anaesthetics in supraclavicular brachial plexus block reduces the time to onset of sensory and motor blockage and prolonged duration of postoperative analgesia.
Highlights
The brachial plexus block for upper limb surgery has proved to be a safer and effective method of regional anaesthesia
It is a common observation that surgeries on upper limb are still being performed mainly under general anaesthesia despite unanimous consensus toward regional anaesthesia, due to one or the other reasons [1]
Regional anesthesia has been increasing in popularity in recent years; this is mainly because of the fact that the regional anesthesia techniques can be utilized for analgesia during the operative period, but during the postoperative period as well and avoids complications of general anaesthesia
Summary
The brachial plexus block for upper limb surgery has proved to be a safer and effective method of regional anaesthesia. Local anesthetics alone for supraclavicular brachial plexus block provide good operative conditions but have shorter duration of postoperative analgesia. This problem can be overcome by using long acting local anesthetics like bupivacaine or ropivacaine or by using adjuvant in regional anesthesia. Steroids have powerful anti-inflammatory as well as analgesic property. They relive pain by reducing inflammation and blocking transmission of nociceptive c-fibres and by suppressing ectopic neural discharge [9]. Some study demonstrated the analgesic effect of systemic corticosteroid in combination with bupivacaine [10,11,12]
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