Key result
Dexamethasone added to bupivacaine accelerates sensory block onset by ~6 minutes and prolongs motor block.
Why the study?
Does adding dexamethasone to bupivacaine improve the onset and duration of sensory and motor blockade in adult patients undergoing upper limb elective surgeries?
RCT (n=60)
Single-blind
Computer generated randomized number
No
Does adding dexamethasone to bupivacaine improve the onset and duration of sensory and motor blockade in adult patients undergoing upper limb elective surgeries?
Absolute Event Rate: 10.57% vs 16.47%
p-value: p=<0.001
Adding 8mg dexamethasone to 0.5% bupivacaine for supraclavicular brachial plexus block significantly accelerates the onset of sensory and motor blockade and prolongs the duration of motor blockade and analgesia.
Supports dexamethasone adjunct for supraclavicular blocks in upper limb surgery; confirms perineural steroid efficacy in RCTs.
Background: Initially the concept of pain was emotional rather than a sensory modality. The word pain is acquired from the Greek word poine which means “penalty”.1 The International Association for the Study of Pain (IASP) described pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage”.2 Peripheral nerve blocks have become a popular anaesthetic option in the perioperative management of patients because nerve blocks provide better postoperative analgesia than does general anaesthesia, while avoiding the cardiopulmonary and central nervous system effects of general anaesthesia. Peripheral nerve block is a technique which uses local anaesthetic to be deposited around a target nerve and block the conduction of action potential thus not allowing pain signals to be transmitted to the pain centre in the brain. Materials & methods: A prospective randomised single blinded study was conducted at Vinayaka Missions Kirupananda Variyar Medical College & Hospitals, Salem from December 2019 to May 2021.
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Swadika et al. (2022) conducted an RCT in Upper limb elective surgeries (n=60). Bupivacaine 0.5% + Dexamethasone 8mg vs. 30ml Bupivacaine 0.5% was evaluated on Onset of sensory block (minutes) (p=<0.001). Adding 8mg dexamethasone to 0.5% bupivacaine for supraclavicular brachial plexus block significantly accelerated the onset of sensory block (10.57 vs 16.47 minutes) and prolonged motor block duration.
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