Effect of Addition of Dexamethasone to Local Anaesthetics in Supraclavicular Brachial Plexus Block

Abstract

Background: In many cases, local anesthesia may be just as effective as general. The regional embargo has been maintained with the use of several additives. Objective: In this study our main goal is to evaluate the effect of dexamethasone added to local anaesthetics on the onset and duration of supraclavicular brachial plexus block. Method: This cross sectional study was carried out at tertiary hospital from January 2021 to January 2022. Where 100 adult patients undergoing various orthopaedic surgeries on forearm and around the elbow under supraclavicular brachial plexus block were selected and divided into 2 groups of 50 each. In group-A patients received 35 ml of mixture of lignocaine 2%, bupivacaine 0.5% while in group-B patients received the same amount of local anaesthetics with dexamethasone (8 mg). The onset of sensory and motor block and duration of analgesia in two groups were compared and development of complications was observed. Results: During the study most of the patients belong to 41-50 years age group for both Group A (48%) and group B (42%). Group A 80% were male and 20% were female. In Group B 90% and 10% were male and female respectively. Onset of sensory as well as motor blocks were early in group B and was statistically significant (p<0.05) too. Duration of analgesia was markedly prolonged in group B and was statistically highly significant (p< 0.001). Plus in group A horners syndrome cases were 45% followed by 7% had Dyspnoea or chest discomfort 3% had Recurrent laryngeal nerve block and 2% had Inadequate block. Whereas in group B horners syndrome cases were 31% followed by 5% had Dyspnoea or chest discomfort 2% had recurrent laryngeal nerve block and 1% had inadequate block. Conclusion: Dexamethasone is not recommended for use in extending the effects of local anesthetics. It might be helpful in conditions where epinephrine usage is restricted (such as high blood pressure or heart disease).