EFFECT OF DEXAMETHASONE AS AN ADJUVANT TO BUPIVACAINE IN ULTRASOUND GUIDED INTERSCALENE BRACHIAL PLEXUS BLOCK IN UPPER ARM SURGERIES

Background:Ultrasound (US) in regional anaesthesia offers a new standard in nerve location and identification, allows real-time imaging of nerves and direct needle guidance.In present study we have access efficacy and safety of Dexamethasone as adjuvant to US guided Interscalene block for Upper arm surgeries. Aims:The study was conducted to compare the efficacy of Dexamethasone as an adjuvant to Bupivacaine in ultrasound guided interscalene brachial plexus block to provide intraoperative anaesthesia and postoperative analgesia in patients undergoing upper arm surgeries and to evaluate Hemodynamic Stability Methods:Present study was conducted at tertiary care hospital on 60 patients posted for elective upper arm surgeries, with ASA grade I and II, in age group of 18-70 years. The patients were randomly divided into 2 groups – Group A and Group B. All patients were given ultrasound guided interscalene block with 15 ml of 0.5% Plain Bupivacaine. Inj. Dexamethasone 8mg was added to local anaesthetic drug in Group A and 0.9% normal saline 2ml was added in Group B. All patients received 17 ml of volume of study drug perineurally. All blocks were successful to provide surgical anaesthesia and analgesia.Both the groups were evaluated for onset and duration of sensory and motor blockade, duration of analgesia, perioperative haemodynamic stability, total number of analgesic requests in 24 hours and any adverse reactions/complications. Results: Both the groups were comparable with respect to patient characteristics. In our study, Onset of sensory block was faster in Group A (3.866 ± 1.33 mins)compared to Group B (7.566 ± 1.67 mins) (p value <0.0001). Onset of motor block was faster in Group A (7.933mins) compared to Group B (11.733 mins) (p <0.0001). Duration of mean sensory block was longer in Group A (904 mins) compared to Group B (305.33mins)(p<0.0001).Duration of mean motor block was longer in Group A (861 mins) compared to Group B (264.33mins) (p< 0.0001). Mean Duration of analgesia was longer in Group A (1455.86 mins)compared to Group B (806.16 mins) (p<0.0001). Total number of analgesic requests was less in Group A (1.2 ) compared to Group B (2.37 ) (p <0.0001).Both groups showed perioperative haemodynamic stability. And no adverse reactions or complications were observed in any patient in Group A, whereas 2 patients (6.67%) in Group B had Postoperative Nausea Vomiting.