Comparison of two doses of Dexamethasone added as adjuvant for ultrasound guided supraclavicular brachial plexus block: A prospective, randomised, double blind study.

Dr. Dheeraj R. Patel; Dr. Chirag Babu P. S; Dr. Kiran B. R; Dr. Arun Kumar Ajjappa

Volume : II, Issue : XII, December - 2013

Comparison of two doses of Dexamethasone added as adjuvant for ultrasound guided supraclavicular brachial plexus block: A prospective, randomised, double blind study.

Dr. Dheeraj R. Patel , Dr. Chirag Babu P. S, Dr. Kiran B. R, Dr. Arun Kumar Ajjappa

Abstract :

BACKGROUND: Dexamethasone as an adjuvant in achial plexus block has been reported to prolong the duration of action of local anesthetic. We performed a prospective, randomised, double blind study to evaluate the effect of two doses of dexamethasone added to local anaesthetic on the onset and duration of supraclavicular achial plexus block, as there is a need to evaluate the optimal dose of dexamethasone to be used in plexus block.

METHODS: 90 adult patients undergoing ultrasound-guided supraclavicular achial plexus block were randomly divided into 3groups of 30 each. In group1 patients received 15ml of 2% lignocaine with adrenaline +15ml of 0.5% bupivacaine +2ml of normal saline(NS), in group2 patients received 15 ml of 2% lignocaine with adrenaline +15ml of 0.5% bupivacaine + 1ml of dexamethasone (4mg)+ 1ml of NS, in group3 patients received 15ml of 2% lignocaine with adrenaline +15ml of 0.5% bupivacaine + 2ml of Dexamethasone (8mg). The onset and duration of sensory and motor blockade in all the groups were compared. Statistical analysis was done using one way ANOVA test and post hoc test.

RESULTS: The groups were comparable in demographic data. The onset of sensory and motor blockade in group 3 [169.83�30.157 sec ; 237.67�31.287 sec ] were significantly more rapid compared to group 2 [228.33�32.386 sec ; 313.33�33.767 sec ] and group 1 [328.50�40.538 sec ; 405.50�41.259 sec] [ p<0.001 (HS) ]. The duration of motor blockade in group 3 [653.33�57.630 min] was significantly longer compared to group 2 [479.83�37.312 min] and group 1 [325.33�36.434 min] [p<0.001(HS)]. In addition the duration of analgesia in group 3 [766.50�46.278 min] was significantly more compared to group2 [601.67�58.492 min] and group1 [390.50�38.019 min] [p<0.001(HS)].

CONCLUSION: Higher dose(8mg) of dexamethasone is more efficacious than lower dose(4mg) of dexamethasone as an adjuvant with local anaesthetic in supraclavicular achial plexus block.