Key result
Adding dexamethasone to bupivacaine prolongs supraclavicular sensory block duration by ~300%.
Why the study?
The study was conducted to compare the onset and duration of sensory and motor block after adding dexamethasone to bupivacaine for supraclavicular brachial plexus block in patients undergoing upper limb surgeries.
Does adding dexamethasone to bupivacaine improve the onset and duration of sensory and motor block in patients undergoing upper limb surgeries?
RCT (n=100)
Double-blind
Sealed envelope technique
No
Does adding dexamethasone to bupivacaine improve the onset and duration of sensory and motor block in patients undergoing upper limb surgeries?
Absolute Event Rate: 1160% vs 289.5%
p-value: p=<0.0001
Adding dexamethasone to bupivacaine in supraclavicular block significantly shortens onset time and prolongs the duration of sensory and motor blockade without systemic side effects.
Supports dexamethasone addition to bupivacaine supraclavicular blocks for extended analgesia; confirms benefit in this RCT.
Objective: Brachial plexus block using bupivacaine as compared to general anesthesia is regarded as a valuable alternative as it induces adequate muscle relaxation, excellent analgesia intra and post operatively. Dexamethasone was combined with bupivacaine to study its effects in terms of onset and duration of sensory and motor block after their administration in patients undergoing upper limb surgeries by implementing the supraclavicular block. Materials and methods: Brachial plexus block is a viable alternative to general anesthesia as it provides adequate muscle relaxation, excellent intraoperative and post-operative analgesia. Dexamethasone, a synthetic glucocorticoid was combined with local anesthetics to study the effects. This study was conducted to compare the onset and duration of sensory and motor block following administration of either bupivacaine and bupivacaine-Dexamethasone in patients undergoing upper limb surgeries under USG guided supraclavicular block. Materials and methods: 100 ASA II, III, IV patients between of 18 and 79 years who underwent elective upper limb surgeries randomly allocated into two groups of 50 each by a sealed envelope technique to receive 20 ml of 0.5% Bupivacaine and 2 ml of normal saline in Group BS and 20 ml of 0.5% Bupivacaine with 2ml (8mg) of Dexamethasone in Group BD. The onset and duration of sensory and motor blockade were observed between the two groups in addition to analgesic effect duration. Results: The onset of sensory and motor blockade was faster in Group BD when compared to Group BS (p<0.0001). The duration of sensory and motor blockade was longer in Group BD when compared to Group BS (p<0.0001). There were no significant hemodynamic changes in the study group. Conclusion: Dexamethasone when added to Bupivacaine in supraclavicular block shortens the onset time and prolongs the duration of sensory and motor blockade without any systemic side effects.
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Khaleel et al. (2020) conducted an RCT in Elective upper-limb surgeries (n=100). Bupivacaine with Dexamethasone vs. 20 ml of 0.5% bupivacaine + 2 ml of normal saline was evaluated on Duration of sensory block (minutes) (p=<0.0001). The addition of 8 mg dexamethasone to bupivacaine for supraclavicular block significantly prolonged the mean duration of sensory block from 289.5 to 1160 minutes.
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