Evaluation Of Analgesic Effect Of Two Different Doses Of Dexamethasone As An Adjuvant To 0.5% Bupivacaine In Ultrasound Guided Supraclavicular Brachial Plexus Block- A Randomized Double Blinded Controlled Study

Introduction: Pain is a major problem in perioperative care. Supplementation of adjuvant along with local anaesthetic agent escalates the duration of analgesia in supraclavicular brachial plexus block and also decreases the requirements of intravenous analgesics. Comparison of the two different doses of Dexamethasone as an adjuvant to Bupivacaine was done for post operative pain management in ultrasound-guided Supraclavicular brachial plexus block. Aim: The aim of the study was to evaluate and compare the duration of analgesia with two different doses of Dexamethasone (8mg Vs 4 mg) as an adjuvant to Bupivacaine in ultrasound-guided supraclavicular brachial plexus block. Materials and methods: A randomized comparative double-blinded study was conducted in Thirty-six patients of age 18-65 years of ASA Ⅰ & Ⅱ scheduled for upper limb surgery under US-guided Supraclavicular brachial plexus block and were divided into three groups consisting of 12 patients each, Group D8 received 20 ml of 0.5% Bupivacaine and 2 ml of Dexamethasone 8 mg, Group D4 Patients received 20 ml of 0.5% Bupivacaine with 1ml normal saline (NS) and 1ml Dexamethasone 4 mg (Total volume of 22 ml) and Group B received 20 ml of 0.5% Bupivacaine with 2 ml (NS) (Total volume 22 ml). Duration of postoperative analgesia was recorded by using 100 points visual analogue scale (VAS). Results: Demographic and surgical characteristics were similar in all three groups. Mean ± SD of duration of analgesia in group D8 was 1021.17 ± 251.19 minutes which was significantly higher as compared to groups D4 (688.5 ± 174.41 minutes, p value<.0001) and group B (523 ± 84.59 minutes, p value<.0001). Duration of analgesia in D4 was also significantly higher as compared to group B (p=0.034). Conclusion: It is concluded that Inj Dexamethasone 8 mg as adjuvant to Bupivacaine significantly increases the duration of analgesia as compared to Dexamethasone 4 mg in ultrasound guided supraclavicular brachial plexus block.