Effect of Intravenous Dexamethasone in Prolonging the Duration of Supraclavicular Brachial Plexus Block with 0.5% Ropivacaine: A Prospective, Randomized, Placebo Controlled Study
Abstract
Background: Supraclavicular brachial plexus block provides excellent, but time limited analgesia. In this study, we evaluated
the effect of intravenous (IV) dexamethasone on the duration of the supraclavicular brachial plexus block with ropivacaine. The
primary end points were onset and total duration of sensory and motor block, quality of analgesia and duration of analgesia.
Materials and Methods: After obtaining Institutional Ethical Committee’s approval and getting informed consent from the patients,
80 patients were divided into two groups RD and R comprising of 40 each in a randomized, double blinded fashion. Group RD
received 30 ml of 0.5% ropivacaine with IV dexamethasone 10 mg (2.5 ml). Group R received 30 ml of ropivacaine with IV
2.5 ml of normal saline. Motor and sensory block onset times, block duration, quality and duration of analgesia were recorded.
Results: Demographic and surgical characteristics were similar in both the groups. The mean duration of analgesia in Group RD
was 934 ± 68 min (15.56 h), whereas in Group R, it was 342 ± 48.7 min (5.7 h) (P < 0.0001). The mean duration of motor block
in Group RD and Group R were 425 ± 38.2 min (11.12 h) and 226 ± 36.4 min (6.2 h), respectively (P < 0.0001). Both these
data were highly signifi cant statistically.
Conclusion: IV dexamethasone signifi cantly prolongs the analgesic duration of single-shot supraclavicular brachial plexus
block with ropivacaine. As dexamethsone is not licensed for perineural use, clinicians should consider IV administration of
dexamethasone to achieve increased duration of analgesia.
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