Perineural versus Systemic Dexamethasone to Prolong Analgesia after ultrasound guided Inter-Scalene Brachial Plexsus Block in Arthroscopic Shoulder 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. Neuraxial block is used for postoperative pain management and decrease analgesic use. Shoulder arthroscopy is a very common surgery and performed as a day case surgery and needs good postoperative analgesia. 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 interscalene brachial plexus nerve block. The