A DOUBLE-BLINDED RANDOMIZED CONTROLLED STUDY IN PATIENTS UNDERGOING FOREARM AND HAND SURGERIES TO STUDY THE EFFECT OF LOW DOSE DEXAMETHASONE AS AN ADJUVANT TO ROPIVACAINE IN AXILLARY BRACHIAL PLEXUS BLOCK”

Introduction: Ultrasound-guided axillary brachial plexus block is commonly used for forearm and hand surgery. Perineural dexamethasone 8mg has proved to prolong the duration of analgesia, but studies with low doses of dexamethasone are scarce. Hence this study was designed to determine the duration of analgesia with 2 mg dexamethasone used perineurally with ropivacaine. Methods: Fifty-Eight patients scheduled for forearm and hand surgeries were included in our study and randomly allocated into two groups. Group R- Axillary Brachial Plexus Block given with 0.75% Ropivacaine 18 ml and 2ml NS and Group RD- Axillary Brachial Plexus Block given with 0.75% Ropivacaine 18 ml and 2 mg Dexamethasone making a total volume of 20ml. Results: Four patients were excluded because of block failure. The time of first rescue analgesia in Group RD was 515.74±11.07 minutes and in Group R was 452.78±14.76 minutes and was statistically significant. Onset of sensory block and motor block in Group RD was earlier than in Group R and duration of sensory and motor block was also longer in Group RD. In Group RD, the VAS score at 8th hour was higher in Group R with 4.63 ±0.49 Vs 2.19±0.48. VAS score at 10th hour was higher in Group RD with 5 ±0.62 Vs 1.22±0.97 in Group R. There was a significant difference in the doses of rescue analgesia between both the groups with p value<0.001 with Group R requiring higher doses of rescue analgesia in 24 hours. Conclusion: A combination of 0.75% Ropivacaine with low dose dexamethasone can be used safely as an adjunct to local anaesthetic in patients with higher safety profile and also provides marginal prolongation of postoperative analgesia.