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

Background: The addition of dexamethasone to local anesthetics in supraclavicular brachial plexus block has been studied to evaluate its impact on block onset and duration, potentially enhancing the efficacy of regional anesthesia.

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.

Methods: This cross-sectional study was carried out at tertiary hospital from January 2022 to January 2023. 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 were observed.

Results: Both Group A (48%) and Group B (42%), where most of the patients in the research are located, have a median age of 41 years. There were 80% males and 20% females in Group A. There were ninety males and ten females in Group B. There was a statistically significant (p 0.05) early onset of sensory and motor block in group B. The analgesic effect lasted much longer in group B (p 0.001) than in group A. In addition, 45% of group A participants were diagnosed with Horner's syndrome, and 7% had Dyspnoea or chest pain. The recurrent laryngeal nerve was blocked in 3% of patients, whereas 2% had insufficient occlusion. In group B, 31% of people experienced horners syndrome, and 5% had Dyspnoea or chest pain. Two percent of patients had a block of the recurrent laryngeal nerve, with one percent experiencing an inadequate block.

Conclusion: Addition of dexamethasone to 1.5% lidocaine with adrenaline in supraclavicular brachial plexus block speeds the onset and prolongs the duration of sensory and motor blockade. However, the use of dexamethasone to prolong the effects of local anesthetics is not encouraged. It might be useful in situations when epinephrine use is limited (such as in hypertension or cardiovascular disease).