A COMPARATIVE OBSERVATIONAL STUDY OF ROPIVACAINE WITH DEXAMETHASONE VERSUS ROPIVACAINE WITH BUPRENORPHINE IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK

Background: Supraclavicular brachial plexus block is a widely used regional anesthetic technique for upper limb surgeries, offering excellent intraoperative and postoperative analgesia. However,the duration of analgesia from local anesthetics like ropivacaine is often limited,prompting the use of adjuvants to enhance and prolong the block's efficacy. Among the commonly used adjuvants, dexamethasone and buprenorphine have gained popularity due to their effectiveness in enhancing analgesia without significant complications.Aim: This study aimed to compare the onset, duration, and efficacy of supraclavicular brachial plexus block using ropivacaine with dexamethasone (RD) versus ropivacaine with buprenorphine (RB) in patients undergoing upper limb surgeries.Methods:A prospective observational study was conducted on 60 patients aged 20–45 years,classified as ASA I–III,and posted for elective upper limb orthopaedic procedures.Patients were randomly assigned into two equal groups:Group RD received 30 ml of 0.5% ropivacaine with 4 mg dexamethasone,and Group RB received 30 ml of 0.5% ropivacaine with 3 mcg/kg buprenorphine. Parameters assessed included the onset and duration of sensory and motor block, time to first rescue analgesia, and hemodynamic stability.Results: Group RD showed a significantly prolonged duration of sensory block (19.68 ± 2.53 hrs vs.12.25 ± 2.53 hrs),motor block (14.81 ± 2.24 hrs vs.9.06 ± 1.97 hrs),and delayed time to first rescue analgesia (21.78 ± 2.08 hrs vs.14.73 ± 1.81 hrs) compared to Group RB (p < 0.001).Hemodynamic parameters and incidence of side effects were comparable between groups.Conclusion: The addition of dexamethasone to ropivacaine in supraclavicular brachial plexus block resulted in significantly longer sensory and motor blockade and delayed need for rescue analgesia compared to buprenorphine,indicating that dexamethasone may be a more effective adjuvant in prolonging postoperative analgesia.This study supports the use of ropivacaine with dexamethasone as a preferred combination for supraclavicular brachial plexus block in upper limb surgeries.