Journal of AdvancedMedical and Dental Sciences Research

Background: Although providing shorter post-surgical analgesia, local anesthetics alone for Supraclavicular brachial plexus block provide good operative conditions. Steroids have powerful anti-inflammatory as well as analgesic property. One of the potent and highly selective glucocorticoid is Dexamethasone. Hence; we assessed the role of dexamethasone as an adjuvant in supraclavicular block for upper limb surgeries. Material & Methods: The present study was conducted in the department of orthopaedics and included all the patients that were admitted to the department from 2011 to 2014 who were planned to undergo below shoulder upper limb surgeries (both elective and emergency) under brachial plexus block. A total of 100 patients were included for the present study and were divided randomly into two study groups. Group A consisted of patients who received bupivacaine with dexamethasone while group B consisted of patients who received only bupivacaine. Both the groups consisted of 50 patients each. Sensory and motor blockade of radial, median, musculocutaneous, medial cutaneous nerve of arm and forearm, and ulnar nerves were assessed every 2 minute after completion of injection till 30 minutes and then every 30 min after the end of surgery till first 12 hrs, thereafter hourly until the block had completely worn off. The duration of sensory block was defined as the time interval between the onset of sensory block and the first postoperative pain. The duration of motor block was defined as the time interval between the onset of motor block and complete recovery of motor functions. After 30 minutes, if the block was considered to be adequate, surgery commenced. All the results were analyzed by SPSS software. Results: Mean age of the patients in group A and group B was 29.5 and 22.4 years respectively. Mean weight of the patients in the group A and group B was 58.3 and 62.1 kg respectively. 170 cm and 168.4 cm was the mean height of the patients in the group A and group B respectively. Mean duration of surgery in group A and group B was 166.5 and 155.2 minutes respectively. Non-significant results were obtained while comparing the two study groups. Mean duration time for the onset of the sensory block in group A and group B patients was 5.01 and 6.70 minutes respectively. Mena duration of analgesia in group A and group B patients was 840 and 280 minutes respectively. Statistically significant results were obtained while comparing the p-value for the mean analgesia time and motor block duration time in between the patients of the two study groups. Conclusion: Significant prolongation of the duration of analgesia and motor block in patients undergoing upper limb surgeries by the addition of dexamethasone to local anaesthetic drugs in brachial plexus block
Key words: Anaesthesia, Dexamethasone, Supraclavicular