Effect of dexamethasone in low volume supraclavicular brachial plexus block: A double-blinded randomized clinical study.
OBJECTIVE
With the use of ultrasound, a minimal effective volume of 20 ml has been described for supraclavicular brachial plexus block. However achieving a long duration of analgesia with this minimal volume remains a challenge. We aimed to determine the effect of dexamethasone on onset and duration of analgesia in low volume supraclavicular brachial plexus block.


METHODS
Sixty patients were randomly divided into two groups of 30 each. Group C received saline (2 ml) + 20 ml of 0.5% bupivacaine and Group D received dexamethasone (8 mg) + 20 ml of 0.5% bupivacaine in supraclavicular brachial plexus block. Hemodynamic variables and visual analog scale (VAS) score were noted at regular intervals until 450 min. The onset and duration of sensory and motor block were measured. The incidence of "Halo" around brachial plexus was observed. Student's t-test and Chi-square test were used for statistical analysis.


RESULTS
The onset of sensory and motor block was significantly earlier in dexamethasone group (10.36 ± 1.99 and 12 ± 1.64) minutes compared to control group (12.9 ± 2.23 and 18.03 ± 2.41) minutes. The duration of sensory and motor block was significantly prolonged in dexamethasone group (366 ± 28.11 and 337.33 ± 28.75) minutes compared to control group (242.66 ± 26.38 and 213 ± 26.80) minutes. The VAS score was significantly lower in dexamethasone group after 210 min. "Halo" was present around the brachial plexus in all patients in both the groups.


CONCLUSIONS
Dexamethasone addition significantly increases the duration of analgesia in patients receiving low volume supraclavicular brachial plexus block. No significant side-effects were seen in patients receiving dexamethasone as an adjunct.
Department of Anaesthesiology, Chettinad Academy of Research and Education, Kanchipuram, Tamil Nadu, India.
Arun Kumar
AK
Alarasan
Department of Anaesthesiology, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India.
Jitendre
J
Agrawal
Department of Anaesthesiology, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India.
Bhanu
B
Choudhary
Department of Anaesthesiology, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India.
Amrita
A
Melhotra
Department of Anaesthesiology, Bundelkhand Medical College, Sagar, Madhya Pradesh, India.
Satyendre
S
Uike
Department of Anaesthesiology, Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, West Bengal, India.
Arghya
A
Mukherji
Analgesia; brachial plexus block; dexamethasone