DOES THE ADDITION OF DEXAMETHASON TO LOCAL ANESTHETIC PROLONG THE ANALGESIA OF INTERSCALEN PLEXUS BRACHIALIS BLOCK IN PATIENTS WITH SHOULDER SURGERY

Introduction: Peripherial nerve blocks is a suitable alternative to general anesthesia especially for one-day case surgery. Interscalene approach of ple- xus brachialis block as much as supraclavicular and in- fraclavicular provide reliable, safe, effective, low cost and most complete anesthesia with satisfactory postop- erative analgesia for upper limb surgery. Postoperative analgesia of plexus brachialis blocks can be prolonged by using different drugs as adjuvants with local anest- hetics. Dexamethasone has been shown to prolong the duration of postoperative analgesia when given as an adjunct for peripheral nerve blocks. The investigation was randomized, prospective, double blinded and con- trolled study. Objective: The study was designed to compare the effects of dexamethasone administered as an ad- junct to bupivacaine in interscalene brachial plexus block on the onset, duration and postoperative analge- sia in patients under the shoulder surgery. Methods: A prospective, double-blind study was undertaken in patients scheduled for shoulder surgeries under the interscalene brachial plexus block. We enrolled 60 patients, ASA I-II both sexes, aged 19-65 years, weig- hing 54-89 kg, divided to two groups G1 and G2. The brachial plexus block was performed by interscalene ap- proach and mixture of 2% lidocaine (12 ml) and 0.5% bu- pivacaine (22 ml) either alone or combined with dexa- methasone (4 mg). The block was performed by using double technique neurostimulator/ultrasound technique. Results: In our investigation we found a signifi- cant increase in onset and duration of motor and sen- sory block in Group G2 (with dexamethasone) as com- pared to Group G1 patients (p < 0.01). Conclusion: Addition of dexamethasone to local anesthetic drugs in interscalene plexus brachialis block, significantly prolongs the duration of analgesia and motor block in patients undergoing shoulder arthro- scopy. Moreover, it is a remarkably safe and cost effec-