Efficacy of perineural versus systemic dexamethasone in prolonging analgesia after ultrasound guided femoral and sciatic nerve block for patients undergoing below knee surgeries

Abstract

Poorly controlled acute pain after surgery is associated with a variety of unwanted postoperative consequences, including patient suffering, distress, myocardial ischemia, prolonged hospital stay and increase of chronic pain. Neuroaxial block is used for postoperative pain management and decrease analgesic use. Many adjuvant drugs are added to bupivacaine to prolong the duration of sensory block like opioids and dexamethasone. Clinically, Dexamethasone is a synthetic glucocorticoid with anti-inflammatory & immunosuppressant properties which has a rapid onset & long duration of action. Adverse effects are extremely rare and not reported for perineural injection however, minimal adverse effects were reported for systemic injection. The aim of this thesis was to study the effect of adding both perineural & systemic dexamethasone as an adjuvant to bupivacaine in femoral and sciatic nerve block. The comparison included the effect on haemodynamics, postoperative pain & postoperative analgesic requirement. In our study, 50 patients were randomly divided into two equal groups: