Evaluation of Dexamethasone as an Adjuvant to Levobupivacaine in Erector Spinae Plane Block for Postoperative Analgesia in Patients Undergoing Modified Radical Mastectomy: A Prospective Randomised Study

Objective Breast surgery is often followed by severe pain. Erector spinae plane block (ESPB), a regional technique used to manage postsurgical pain as well as acute and chronic pain. Adding an adjuvant to ESPB can improve its quality and efficacy. We conducted a study to evaluate the effect of adding dexamethasone to ESPB for postoperative analgesia following modified radical mastectomy (MRM) under general anaesthesia. Methods The study was conducted on 60 female patients posted for ultrasound-guided ESPB in MRM. These patients were randomly divided into two groups before the induction of general anaesthesia. In Group L, patients were given ESPB with 20 ml of 0.25% levobupivacaine plus normal saline, whereas in Group D, patients were given ESPB with 20 ml of 0.25% levobupivacaine plus 4 mg dexamethasone. Tramadol was given as a rescue analgesic. The duration of analgesia, verbal numerical rating scores, postoperative analgesic consumption, patient satisfaction and side effects were evaluated. Results The duration of analgesia was significantly longer in Group D (982.3 ± 65.7 min) when compared to Group L (711.0 ± 68.9 min) ( P < .001). Total requirement of tramadol was significantly lower in Group D (133.33 ± 47.95 mg) compared to Group L (230.00 ± 46.61 mg) ( P < .001). The VNRS scores in Group D were significantly lower compared to Group L at rest. Patients in Group D experienced higher satisfaction compared to Group L. Conclusions Dexamethasone with levobupivacaine in ESPB for MRM provides increased duration of analgesia and decreased rescue analgesic consumption with better quality of analgesia and patient satisfaction.