Brachial Plexus block is an excellent alternative to general anaesthesia for a wide variety of upper limb procedures and is a useful analgesic component for major elective and emergency surgeries. It provides a superior quality of analgesia and avoids the common side effects associated with general anaesthesia such as postoperative nausea and vomiting Aim: To compare the efficacy of perineural dexamethasone with intravenous dexamethasone as an adjuvant to bupivacaine in Supraclavicular brachial plexus block. Setting: Randomized controlled single blind study. Methods: Group I (Control) received bupivacaine 0.375% 30ml. Group II received bupivacaine 0.375% 30ml and 8mg dexamethasone intravenously. Group III received bupivacaine 0.375% 30ml and 8mg dexamethasone perineurally. Statistics: Chi square is used to compare categorical values. One way ANOVA is used to determine whether there are any statistically significant differences between the means of more than two independent (unrelated) groups. Results: With respect to mean time for first rescue analgesic need, its duration was maximum in perineural Dexamethasonegroup (7.84±0.37 hrs) as compared to intravenous Dexamethasone (6.28±0.46hrs) and Control group (4.72±0.47 hrs). Statistically, this difference was significant. In 24hrs, total number of Rescue analgesia used was minimum for group III with mean 2.76±0.44 and maximum for group I with mean 3.20±0.41. The difference in amount of rescue analgesia used among the three groups was found to be highly significant (p<0.001). Conclusion: Perineural dexamethasone as an adjuvant to bupivacaine in Supraclavicular Brachial Plexus Block delayed the rescue analgesic need by several hours in comparison to intravenous bupivacaine.
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2022: 6.012
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