BACKGROUND Dexamethasone as an adjuvant to local anaesthetics improves the quality and duration of peripheral nerve blocks. The effect of different doses of dexamethasone on the block characteristics remains inconclusive. The present study aimed to evaluate the effects of 4 mg versus 8 mg of dexamethasone with 0.5% bupivacaine in supraclavicular brachial plexus block. METHODS Sixty American Society of Anaesthesiologist's (ASA) grade I-II patients aged 18-70 years scheduled for elective upper limb surgeries under supraclavicular brachial plexus block were enrolled prospectively. Ultrasound guided supraclavicular brachial plexus block was performed with 4 mg or 8 mg dexamethasone as adjuvant to 18 ml of 0.5% bupivacaine depending on randomization. The primary outcome assessed was duration of post-operative analgesia. The secondary outcomes were onset of sensory and motor blockade, duration of sensory and motor blockade and complications. Data was analysed using Chi-square and student's t test and p<0.05 was considered as statistically significant. RESULTS There was no significant difference in onset of sensory and motor blocks. Sensory and motor block duration was significantly higher in Group 2 (p<0.001). The mean duration of postoperative analgesia in group 1 was 604.33 + 48.96 and 1074.0 + 94.01 minutes in group 2 which was significantly higher (p<0.001). CONCLUSIONS Dexamethasone 8 mg as an adjuvant to 0.5% bupivacaine in supraclavicular brachial plexus block significantly prolongs the duration of sensory and motor blockade and post-operative analgesia compared to 4 mg dexamethasone. There is no difference between groups in onset of sensory and motor block.
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