The Effects of Dexamethasone versus Potassium Chloride as Additives to Local Anesthetic in Supraclavicular Brachial Plexus Block

Abstract

Abstract Background Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage. Regional anesthesia of the trunk and the extremities an alternative to general anesthesia in many situations. It avoids the unwanted effects of the anesthetic drugs used during general anesthesia and the stress of laryngoscopy and tracheal intubation. Aim of the Work To compare the clinical efficacy of addition of dexamethasone or potassium chloride to local anesthetic solution of bupivacaine and lignocaine on the onset, duration, quality of analgesia, and quality of sensory and motor blockade in supraclavicular brachial plexus block in patients undergoing upper extremity surgeries. Patients and Methods This study is a prospective double – blinded, randomized trial After obtaining approval from the Research Ethical Committee of faculty of medicine Ain shams University, this study was conducted in the operating theaters of Ain shams University Hospital. Results In the current study, it was obvious that: addition of Dexamethasone to bupivacaine in supraclavicular nerve block shortened the onset times of both sensory and motor blocks than add. Addition of Dexamethasone to bupivacaine significantly prolongs both sensory and motor block durations than injecting dexamethasone intravenously. Addition of Dexamesthasone to bupivacaine prolongs the analgesia of brachial plexus block with subsequent consumption of less amount of analgesics than adding Potassium Chloride. Conclusion The use of ultrasonography in performing the supraclavicular nerve block, decreased significantly the incidence of complications such as pneumothorax or intravascular injection and hence, lowered the incidence of systemic toxicity of local anesthetics.