Effect of Adding Dexamethasone to Bupivacaine in Ultrasound Guided Supraclavicular Brachial Plexus Block Versus Bupivacaine alone for Upper Limb Orthopaedic Surgery: A Comparative Study

Abstract

rachial plexus blocks are among the most commonly performed peripheral nerve blocks for upper extremity surgeries in clinical practice. It offers many advantages over general anaesthesia for upper limb surgeries such as sympathetic block, better postoperative analgesia, high success rate and fewer side effects. Brachial plexus is a complex network of nerves supplying the upper limb, with both sensory and motor supply. It is formed by the convergence of the ventral rami of the spinal nerve roots from C5 to T1. It is composed of 5 roots, 3 trunks (upper, middle and lower), 6 divisions, 3 cords (lateral, medial and posterior) and terminal branches. Among the different approaches to the brachial plexus, the supraclavicular approach is the easiest and most consistent method for anaesthesia and perioperative pain management in surgery below the shoulder joint. Local anaesthetic alone for supraclavicular brachial plexus block provide good operative conditions but have shorter duration of postoperative analgesia. Adjuvants added to brachial plexus block should prolong the analgesia, without having systemic side effects, prolong motor block and should also reduce the total dose of local anaesthetic