Key result
The addition of 8mg dexamethasone to 0.5% ropivacaine in supraclavicular brachial plexus block significantly prolonged the mean duration of analgesia to 690.75 minutes compared to 405.90 minutes with ropivacaine alone.
Why the study?
Ropivacaine has a longer duration of action for upper limb surgeries under brachial plexus block but has drawbacks of delayed onset and patchy analgesia.
Does adding dexamethasone to ropivacaine improve the onset and duration of sensory and motor blockade and prolong analgesia in patients undergoing upper limb surgeries under supraclavicular brachial plexus block?
RCT (n=80)
Double-blinded
Randomised
No
Does adding dexamethasone to ropivacaine improve the onset and duration of sensory and motor blockade and prolong analgesia in patients undergoing upper limb surgeries under supraclavicular brachial plexus block?
Adding 8 mg of dexamethasone to 0.5% ropivacaine for supraclavicular brachial plexus block significantly hastens the onset and prolongs the duration of sensory and motor blockade and analgesia without increasing adverse effects.
May improve block onset and duration with dexamethasone adjunct; leaves open optimal dosing and safety in larger trials.
Brachial plexus block provide a useful alternative to general anaesthesia for upper limb surgeries.Ropivacaine is one of the most frequently used local anaesthetic which has longer duration of action but has drawbacks of delayed onset and patchy analgesia. Dexamethasone is very potent glucocorticoid with very good anti-inflammatory and analgesic activity. A prospective, randomised double blinded study was undertaken in patients posted for upper limb surgeries under supraclavicular block. 80 patients with ASA class I and II were randomly grouped into two groups. Group R received 28ml ropivacaine 0.5% and 2ml normal saline and Group RD received combination of 28ml ropivacaine 0.5% and 2ml/8mg dexamethasone. 30ml solution is used for a single shot blockade of supraclavicular brachial plexus. Combination of ropivacaine 0.5% and dexamethasone 8mg has significantly hasten onset and duration of sensory and motor blockade and prolonged duration of analgesia.
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Pathak et al. (2022) conducted an RCT in Patients undergoing elective upper limb surgeries (n=80). Ropivacaine with Dexamethasone vs. 28ml of 0.5% Ropivacaine + 2ml normal saline was evaluated on Duration of analgesia (minutes) (p=<0.05). The addition of 8mg dexamethasone to 0.5% ropivacaine in supraclavicular brachial plexus block significantly prolonged the mean duration of analgesia to 690.75 minutes compared to 405.90 minutes with ropivacaine alone.
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