INTRODUCTION: Duration of analgesia provided by brachial plexus block can be prolonged by simultaneous administration of intravenous dexamethasone.
METHODS: Thirty adult patients undergoing upper limb surgery receiving supraclavicular brachial plexus block (SBPB) with 30 mL 0.5% ropivacaine were randomly allocated to receive 10 mg dexa-methasone (Group RD) or normal saline (Group R) intravenously just before the block. The primary outcome was duration of analgesia. Secondary outcomes included duration of sensory and motor block, pain scores, time to readiness to discharge, quality of sleep, patient satisfaction and postoperative analgesic requirement.
RESULTS: Demographic data was comparable in both groups. The mean duration of analgesia was 19.00±3.07 hrs in Group RD as compared to 9.47±1.82 hrs in Group R (p<0.001). Mean duration of sensory block was 16.93±2.84 hrs in Group RD versus 7.77±1.92 hrs in Group R (p<0.001) while mean duration of motor block was 9.40±2.96 hrs and 4.77±1.10 hrs in Groups RD and R respectively (p<0.001). Pain scores of patients in Group R were significantly higher from 9th to 24th hour postoperatively. The number of patients requiring additional analgesia was almost 2-fold more numerous in Group R (80%) as compared to Group RD (40%) (p=0.021). The PADSS score, rise in blood sugar, sleep quality and patient satisfaction were similar in both groups.
DISCUSSION AND CONCLUSION: The administration of single dose of 10 mg intravenous dexamethasone prior to SBPB with ropivacaine is an easy, simple, safe, and effective method to increase the duration of analgesia.