RANDOMISED COMPARATIVE STUDY OF DIFFERENT DOSES OF DEXAMETHASONE AS AN ADJUVANT TO ROPIVACAINE IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK IN UPPER LIMB SURGERY.

JASMEEN CHOWDHARY; NAINE BHADRALA; JAMEEL HUSSAIN

Volume : VIII, Issue : IV, April - 2019

RANDOMISED COMPARATIVE STUDY OF DIFFERENT DOSES OF DEXAMETHASONE AS AN ADJUVANT TO ROPIVACAINE IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK IN UPPER LIMB SURGERY.

Jasmeen Chowdhary, Naine Bhadrala, Jameel Hussain

Abstract :

Background:Upper limb surgeries below the shoulder joint are mostly performed under peripheral blocks such as the achial plexus block. Peripheral nerve blocks not only provide intra–operative anesthesia, but also extend analgesia in the post–operative period without major systemic side–effect by minimizing stress response and using minimal anesthetic drugs.The present study evaluated the effects of different doses of dexamethasone as an adjuvant to 0.75% ropivacaine in producing desired peripheral nerve blockade.MATERIAL AND METHODS:–90 patients posted for upper limb surgeries were selected randomly after taking informed written consent into three groups( 30 patients of ASA I and II in each group) . Group I –received 28 ml of 0.75% ropivacaine +2ml of normal saline, Group II received 28ml 0.75% ropivacaine+ 1 ml dexamethasone(4mg) + 1 ml normal saline and Group III– received 28ml 0.75% ropivacaine+2ml dexamethasone(8mg). Total volume of the drug kept was 30 ml in all the groups.The onset of sensory and motor blockade and duration of sensory and motor blockade were assessed. Results: The demographic profile were comparable in all the three groups.The onset of sensory and motor block were similar among the three groups. The duration of sensory and motor block and time to first analgesic use were significantly longer and the total need for rescue analgesics was lower in group II &III (P < 0.05) than group I .The duration of motor and sensory block were comparable between group II and group III. Post–operative VAS value at 12 h were significantly lower in group II &III(P < 0.05). The systolic blood pressure, diastolic blood pressure, mean arterial pressure, and heart rate showed no significant differences among three groups without any appreciable side effects. Conclusion: Addition of different doses of dexamethasone to supraclavicular achial plexus block increases the sensory and motor block duration and time to first analgesic use, and decreases total analgesic use with no side–effects.No significant difference was seen between high and low dose of dexamethasone.