Key result
Addition of 8 mg dexamethasone to bupivacaine for supraclavicular brachial plexus block significantly prolonged the mean duration of analgesia to 1278.8 minutes compared to 425.6 minutes with bupivacaine alone.
Why the study?
Does the addition of dexamethasone to bupivacaine prolong the duration of analgesia in patients undergoing upper limb surgeries?
RCT (n=50)
Double-blind
Simple random sampling
No
Does the addition of dexamethasone to bupivacaine prolong the duration of analgesia in patients undergoing upper limb surgeries?
The addition of dexamethasone to bupivacaine in supraclavicular brachial plexus block significantly prolongs the duration of analgesia and motor block.
Supports adding perineural dexamethasone for extended analgesia in upper-limb blocks; extends RCT evidence on steroid adjuvants.
BACKGROUND: In this study, we evaluated the effect of Dexamethasone with Bupivacaine compared to Bupivacaine with Normal Saline on the duration of the Supra clavicular block.METHODOLOGY: After obtaining institutional ethical committee's approval and getting informed consent from the patients, 50 patients were randomly divided into two groups D and C comprising of 25 each.We excluded patients less than 50-75kgs weight and patients who had comorbidities like Diabetes Mellitus, Hypertension and people on oral anti-coagulants.Patients were premedicated with Tab.Ranitidine 150mg night before surgery and Inj.Midazolam 0.05mg/kg IM 1hr prior to surgery.Group D received 28 ml of 0.5% bupivacaine with 8 mg (2ml) Dexamethasone.Group C received 28 ml of bupivacaine with 2ml of Normal saline.RESULTS: In our study, the mean duration of analgesia in group D was 1278.8 ± 82.83 minutes (21.3 hrs) whereas in group C it was 425.6 ± 53.31 minutes (7.08 hrs) (p < 0.0001).The mean duration of motor block in group D and group C were 1082 ±80.47minutes (18.03 hrs) and 359.2 ± 55.45 minutes (5.98 hrs) respectively (p < 0.0001).Both these data were highly significant statistically.CONCLUSION: We conclude that addition of Dexamethasone to local anesthetic drugs in supraclavicular brachial plexus block significantly prolongs the duration of analgesia and duration of motor block in patients undergoing upper limb surgeries.
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A et al. (2014) conducted an RCT in Upper extremity surgery requiring supraclavicular brachial plexus block (n=50). Dexamethasone vs. Normal saline was evaluated on Duration of analgesia (minutes) (p=<0.0001). Addition of 8 mg dexamethasone to bupivacaine for supraclavicular brachial plexus block significantly prolonged the mean duration of analgesia to 1278.8 minutes compared to 425.6 minutes with bupivacaine alone.
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