To Compare Efficacy Of Bupivacaine And Bupivacaine With Dexamethasone For Supraclavicular Brachial Plexus Block In Patients Undergoing Upperlimb Surgeries – A One Year Randomised Controlled Trial

Abstract

Brachial plexus block has become a viable alternative to general anaesthesia for upper limb surgeries as it provides adequate muscle relaxation, excellent intra-operative and post-operative analgesia. Bupivacaine is a commonly used local anaesthetic in such blocks. Dexamethasone, a synthetic glucocorticoid was combined with local anaesthetics to prolong the effects of local anaesthetics. AIMS AND OBJECTIVES:- This study was conducted to compare the onset and duration of sensory and motor block following administration of either bupivacaine and bupivacaine- Dexamethasone in patients undergoing upper limb surgeries following supraclavicular brachial plexus block performed under USG guidance. MATERIALS AND METHODS :- This prospective randomised controlled study was carried out in the Department of Anaesthesiology at KLE’s Dr Prabhakar Kore Hospital and Medical Research Center, Belagavi which included 60 ASA grade I and II patients between the ages of 18 and 60 who underwent elective upper limb surgeries. After obtaining ethical committee clearance and informed consent, the patients were randomly allocated into two groups of 30 each by a sealed envelope technique to receive 30 ml of 0.5 % Bupivacaine and 2 ml of normal saline in Group BS and 30 ml of 0.5% Bupivacaine with 2ml (8mg) of Dexamethasone in Group BD. The onset and duration of sensory and motor blockade were observed between the two groups. RESULTS:- The onset of sensory and motor blockade was faster in Group BD when compared to Group BS (p<0.0001). The duration of sensory and motor blockade was longer in Group BD when compared to Group BS (p<0.0001). There were no significant haemodynamic changes in the study group CONCLUSION:- Dexamethasone when added to Bupivacaine for supraclavicular block shortens the onset time and prolongs the duration of sensory and motor blockade without any systemic side effects.