A comparison study of 2 mg versus 4 mg of dexamethasone combined with local anesthetic drug in increasing the analgesic duration of a single-shot supraclavicular brachial plexus block
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Abstract
Background: Addition of dexamethasone to
local anesthetic can prolong the analgesic duration in
peripheral nerve block. However, the proper adding
dose of dexamethasone for brachial plexus block
can not be concluded. Objectives: To compare the
analgesic duration of dexamethasone 2 versus
4 mg added to local anesthetic drugs following
supraclavicular brachial plexus block. Methods: This
study was a double-blinded randomized controlled
trial. Fifty seven patients undergoing upper extremity
surgery were randomly assigned to 3 groups. All
patients received 20 ml of 2% lidocaine with
adrenaline 5 mcg/ml and 10 ml of 0.5% bupivacaine
for supraclavicular brachial plexus block. Same
volume of normal saline, dexamethasone 2 mg and
dexamethasone 4 mg were added to local anesthetics
in C group, Dex2 group and Dex4 group, respectively.
Results: Median and 95% CI of analgesic duration
in Dex2 and Dex4 group were 620(440-837),
894(652-960) minutes which were longer than C group
[335(259-491)] significantly (p-value 0.001). Analgesic
duration in Dex4 group was longer than Dex2 group
(p-value < 0.05). Both of dexamethasone groups had
longer duration of motor block than C group [Dex2
group 525(441-720), Dex4 group 518(467-840),
C group 420(310-483) minutes, p-value 0.0028).
However, there was no difference in duration of
motor block between Dex2 and Dex4 group.
Morphine consumption in C group was more than
both of dexamethasone groups. No adverse events
were noted in all groups. Conclusion: Adding
dexamethasone 4 mg in supraclavicular BPB has
longer duration of analgesia than dexamethasone
2 mg with a comparable duration of motor block.
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