Comparison of Supraclavicular Brachial Plexus Block with and without Dexamethasone as an Adjuvant to Local Anesthetics: An Observational Study

Abstract

Background: Supraclavicular brachial plexus block (SCBPB) is a widely used regional anesthetic technique for upper limb surgeries. While local anesthetics provide effective analgesia, their limited duration often necessitates additional analgesics. Dexamethasone, a corticosteroid with anti-inflammatory properties, has been explored as an adjuvant to prolong block duration and enhance analgesic efficacy.

Aim: To compare the onset time, duration of block, postoperative pain scores, and analgesic consumption in supraclavicular brachial plexus block with and without dexamethasone.

Methods: This observational study included 60 patients undergoing elective upper limb surgeries, randomly divided into two groups of 30 each. Group 1 received local anesthetics (15 ml of 2% lignocaine with adrenaline and 15 ml of 0.5% bupivacaine) with 8 mg dexamethasone (2 ml). Group 2 received the same anesthetic combination with 2 ml normal saline. Data collected included block onset time, duration, pain scores (VAS), total analgesic consumption, and side effects. Statistical analysis was performed using SPSS v23, with p < 0.05 considered significant.

Results: Group 1 showed a significantly faster onset of sensory and motor block (6.2 ± 1.1 min and 8.0 ± 1.4 min) compared to Group 2 (9.1 ± 1.3 min and 11.2 ± 1.6 min, p < 0.001). The duration of sensory and motor blocks was also longer in Group 1 (645.6 ± 48.3 min and 598.7 ± 45.6 min) than in Group 2 (430.2 ± 39.4 min and 405.8 ± 36.2 min, p < 0.001). Postoperative VAS scores were consistently lower, and total analgesic consumption was significantly reduced in the dexamethasone group. No significant difference in adverse effects was observed between the groups.

Conclusion: Dexamethasone as an adjuvant to local anesthetics in SCBPB leads to faster onset, prolonged block duration, and better postoperative pain control without increasing adverse effects.

Recommendations: Larger randomized controlled trials are recommended to confirm these findings and to establish the optimal dexamethasone dose for peripheral nerve blocks.

Keywords: Supraclavicular brachial plexus block, Dexamethasone, Regional anesthesia, Postoperative pain, Local anesthetic adjuvant