Key result
Adding dexamethasone to bupivacaine fails to significantly prolong analgesia versus bupivacaine alone in upper limb surgeries.
Why the study?
The effect of adding dexamethasone to supraclavicular brachial plexus block on anesthesia duration was assessed.
Does adding dexamethasone to bupivacaine for supraclavicular brachial plexus block prolong the duration of analgesia in patients undergoing upper limb surgery?
RCT (n=60)
Double-blind
Randomized
No
Does adding dexamethasone to bupivacaine for supraclavicular brachial plexus block prolong the duration of analgesia in patients undergoing upper limb surgery?
Perineural administration of dexamethasone with bupivacaine significantly prolongs the duration of analgesia in supraclavicular brachial plexus blocks.
Supports adding perineural dexamethasone to bupivacaine for extended analgesia in supraclavicular blocks; confirms prior RCT evidence.
Aim: To assess the effect of supraclavicular brachial plexus block in patients with or without dexamethasone. Study design: Double blind randomized controlled trial Place and duration of study: Department of Anesthesia and Critical Care, The Indus Hospital a free of cost tertiary care hospital in Karachi from 9th May 2019 to 19th February 2020. Methodology: Sixty patients were enrolled with 30 patients in each intervention group. Patients who came for elective or emergency surgery of the upper limb below shoulder were included in the study. Block performed on patients lying supine at 45 degree. The dexamethasone group received 0.25% plain bupivacaine 18 ml with 2ml dexamethasone (0.4mg/ml) and control group received 0.25% plain bupivacaine 18 ml with 2 ml normal saline. Results: The age of the group B patients was higher than the group A patients such as 43.4±15.7 years vs 38.6±14.2 years. The ASA level presented higher scoring than II in patients from Group B with 63.3% those patients who called for pain. In this study the intra operative vital signs showed an insignificant variance in both groups.However, a significant increase in duration of analgesia was observed in group A. Conclusion: Perineural administration of dexamethasone with clinical bupivacaine concentration can prolong the duration of anesthesia.
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Hyder et al. (2022) conducted an RCT in Upper limb surgeries below shoulder (n=60). Dexamethasone vs. 2 ml normal saline was evaluated on Duration of analgesia (p=0.09). Perineural administration of dexamethasone with bupivacaine prolonged the duration of analgesia compared to bupivacaine alone in patients undergoing upper limb surgeries.
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