A CLINICAL COMPARISON BETWEEN 0.5% BUPIVACAINE AND 0.5% BUPIVACAINE DEXAMETHASONE 8mg COMBINATION IN BRACHIAL PLEXUS BLOCK BY SUPRACLAVICULAR APPROACH

Abstract

Aim:To study the onset and duration of sensory and motor blockade\nIntroduction: Brachial plexus block provides a useful alternative to general anaesthesia for upper limb surgeries. Bupivacaine is one of the most\nfrequently used local anaesthetic which has a longer duration of action of 3 to 8 hours but has drawbacks of delayed onset and patchy analgesia.\nDexamethasone is a very potent glucocorticoid with very good anti-in\uf002ammatory and analgesic activity.\nMaterials and methods: A prospective, randomised single-blinded study was undertaken in patients posted for upper limb surgeries under the\nsupraclavicular block. 60 patients with ASA class I and II were randomly grouped into two groups. Group I received 30ml bupivacaine 0.5% and\nGroup II received a combination of 28ml bupivacaine 0.5% and 2ml dexamethasone 8mg. 30ml solution is used for a single shot blockade of\nsupraclavicular brachial plexus.\nResults: Group II patients had a faster onset of action and prolonged duration of action.\nDiscussion: The addition of dexamethasone 8mg to bupivacaine 0.5% speeds the onset of sensory and motor blockade also prolongs the duration\nthus provides better analgesia and reduces the requirements of rescue analgesics.\nConclusion:Acombination of bupivacaine 0.5% and dexamethasone 8mg has a signi\uf001cantly faster onset and prolonged duration of action.