Intravenous Dexamethasone As Adjuvant to Axillary Brachial Plexus Blockade For Forearm Orthopedic

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Intravenous Dexamethasone As Adjuvant to Axillary Brachial Plexus Blockade For Forearm Orthopedic

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Introduction: perineural dexamethasone prolongs the duration of single injection peripheral nerve block when added to the local anesthetic solution while perineural use of dexamethasone remains off-label. Postulated systemic mechanisms of action along with safety concerns have prompted the investigation of intravenous dexamethasone as an alternative. Aim: We aimed to confirm that addition of intravenous dexamethasone will prolong the duration of analgesia after single shot axillary brachial plexus block compared to conventional long acting local anesthetic alone. Material And Method: 46 Asa I to III adult patients scheduled for elective forearm and hand surgeries were randomly allocated to 2 groups of 23 patients each. Patients in group D received axillary brachial plexus block with injection of 30 ml bupivacaine 0.5% and 2 ml of dexamethasone (8mg) IV and Patients in control group A received axillary brachial plexus block with injection of 30 ml of bupivacaine 0.5% and 2ml of 0.9% saline IV prior to surgery. Results: There was a statistically significant difference in duration of post operative analgesia, duration of motor and sensory blockade and better overall patient satisfaction in group D when compared to group A. Conclusion: We concluded that Single shot axillary brachial plexus block with 0.5% bupivacaine and intravenous dexamethasone resulted in prolonged duration of post operative analgesia, sensory and motor blockade and better patient satisfaction

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