Background and Objectives: Variety of adjuvants has been used to prolong the duration of local anaesthetic action after regional and peripheral nerve blocks. We have conducted an observational study on effect of dexamethasone on the onset of analgesia, duration of analgesia and adverse effects in upper limb orthopaedic surgeries performed under low interscalene brachial plexus blockade with the help of peripheral nerve stimulator using ropivacaine as local anaesthetic.

Methods: After ethical committee approval and informed consent from patients we performed a prospective observational study on patients scheduled for upper limb orthopaedic surgeries under low interscalene brachial plexus blockade. This study was done among two groups of patients belonging to ASA 1 and 2 which were comparable with regard to age, sex and weight. They were allocated into two groups using computer generated randomization. group R  received 28mL of 0.5 % ropivacaine with 2mL sterile water (n=20)  and group RD received 28ml of 0.5 % ropivacaine with 2mL dexamethazone (n=20). Computer software SPSS version‑19 (SPSS Inc., Chicago, Illinois, USA) was used for statistical analysis. Student’s t‑test and Chi‑square test were used and P <0.05 was considered as significant. 

Results: The onset of sensory block in group R was 14.1 ± 0.968 min and group RD was 13.85 ± 1.13 min (P = 0.45> 0.05) and the onset of motor block in group R was 15.7  ± 1.3 min and in group RD was 15.35 ± 0.99 min (P = 0.34). The mean duration of analgesia in group R was 521.75 ± 85.98 min and in group RD was 1015.75 ± 34.57 min (P = 0001<0.01). Both groups showed stable hemodynamic conditions and no complications were observed in either of the groups.

Conclusion: Perineural administration of dexamethasone with ropivacaine significantly prolongs duration of analgesia in brachial plexus blockade and is remarkably safe and cost effective method of providing post operative analgesia.

Keywords: Dexamethasone, ropivacaine, interscalene brachial plexus blockade.

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Dr Jasmine P Alex MD

Senior Resident, Govt. TD Medical College Alappuzha