A Prospective Randomised Controlled Double-Blinded Comparative Study of Plain Bupivacaine versus Bupivacaine and Dexamethasone for Supraclavicular Brachial Plexus Block, Government General Hospital, Nizamabad

Abstract

BACKGROUND Dexamethasone (DES) is a very potent anti-inflammatory and analgesic glucocorticoid with very strong activity. The current study is randomised to determine the onset time, duration, and analgesic potency of bupivacaine (BUC) 0.5 percent, relative to BUC 0.5 percent and DES 8 mg by supraclavicular approach for brachial plexus block. METHODS In patients posted for upper limb surgery under a supraclavicular block, a prospective, randomised, double-blinded study was conducted. 60 Class I and II American Society of Anesthesiologists (ASA) patients were randomly divided into two classes. Group A received 0.5 percent of 30 ml BUS and group B received 0.5 percent of 28 ml BUS and 8 mg of 2 ml DES combined. For a single shot blockade of the supraclavicular brachial plexus, 30 ml of a solution was required. RESULTS The mean age of patients who received BUS was 36.9 ± 10.4 years and those who received BUS + DES was 34.7 ± 7.1 years (P = 0.328), there was no statistically significant difference between the mean ages of two groups (P > 0.05). The mean time of onset of sensory block in the BUS group was 8.6 ± 1.2 minutes and 5.6 ± 0.7 minutes in the BUS + DES group. There was a statistically significant difference between the onset of motor block in minutes among BUS and BUS + DES groups, there was a statistically significant difference between the mean ages of the two groups (P < 0.001). There was no statistically meaningful difference between the BUS and BUS + DES classes at various time intervals in the mean heart rate, difference in systolic blood pressure and diastolic blood pressure, and oxygen saturation. CONCLUSIONS The start of sensory and motor blockade also prolongs the length of DES 8 mg to BUS 0.5 percent speeds, thereby supplying improved analgesia and reducing the rescue analgesic requirements. KEYWORDS Bupivacaine, Dexamethasone, Brachial Plexus, Supraclavicular, Sensory Block