BRACHIAL PLEXUS BLOCK

THE EFFECTIVENESS OF DEXAMETHASONE WHEN ADDED TO PRILOCAINE, FOR SENSORY AND MOTOR BLOCKADE, A CASE CONTROL STUDY.

Abstract

Objectives: The aim of our study is to find out the efficacy of dexamethasone
(8mg) on prolonging the duration of motor and sensory blockade as used in brachial plexus
block required for forearm and hand surgeries. Study Design: Prospective randomized double
blind trial. Period: April 2013 to May 2014, for a period of 14 months. Setting: Tertiary care
hospital in Karachi Pakistan. Method: The study population consisted of 42 patients belonging
to ASA classification, grades I and II, who underwent elective surgical procedures involving the
forearm and hand. The patients were divided in to three groups, group A consisted of patients
who were given 2% of prilocaine at 5mg per kg of body weight, group B consisted of patients
who were given 2% of prilocaine with dexamethasone (8mg as 2ml) at group C consisted of
patients who were given 0.5% of levobupivacaine at 1.5mg per kg of body weight. The time
duration and onset of sensory and motor blockade was duly noted for all the three groups.
Data was analyzed using SPSS version 20. Results: The time of onset of motor and sensory
block in group A and B, were very similar, there was a difference of longer duration was duly
noted in group C, which was statistically significant (p<0.001). In terms of the duration of block,
a statistically significant difference was found when compared in the three groups (p<0.001).
The duration of sensory and motor blockade was longer in Group C when compared to the
other two groups, and they were found to be longer in group B when compared with group A
(p<0.001). Side effects were not found in the study population due to small number of patients
evaluated. Conclusion: According to our study the addition of dexamethasone to the prilocaine
used in hand and forearm surgeries resulted in increased duration of the sensory and motor
blockade achieved. While levobupivacaine was found to be a very potent anesthetic when used
locally for post op analgesia requirements and during long procedures.