A Comparative Study of Dexamethasone versus Midazolam as Adjuvant to 0.5% Bupivacaine in Ultrasound-Guided Supraclavicular Brachial Plexus Block for Upper-Limb Surgeries.

BACKGROUND

Ultrasound has been effective in using low volume of local anesthetics for supraclavicular block. Steroids have been shown to increase the duration of local anesthetics.

AIMS AND OBJECTIVES

In this study, we compare the efficacy of dexamethasone versus midazolam when added to bupivacaine in supraclavicular brachial plexus block for upper-limb surgeries with regard to the time of onset and duration of sensory and motor blockades, duration of analgesia, sedation, and hemodynamic parameters.

SETTING AND DESIGN

This is a prospective, randomized, double-blind study conducted on 60 patients belonging to the American Society of Anesthesiologists physical status classes 1 and 2, undergoing upper-limb surgeries under ultrasound-guided supraclavicular brachial plexus block.

MATERIALS AND METHODS

Sixty patients were divided into two groups of 30 each. Group dexamethasone (Group D) received bupivacaine 0.5% 18 mL + dexamethasone 4 mg + 1 mL normal saline. Group midazolam (Group M) received bupivacaine 0.5% 18 mL + 2 mg midazolam. We compared the onset and duration of sensory and motor blocks, hemodynamic variables, pain and sedation scores, and duration of analgesia.

STATISTICAL ANALYSIS

The statistical software, namely SPSS 18.0 and R environment ver. 3.2.2, were used for the analysis of the data. < 0.05 was considered statistically significant.

RESULTS

The onset of sensory and motor blocks was significantly faster in Group D compared to Group M. The duration of sensory and motor blockades and duration of analgesia showed a significant increase in Group D in comparison with Group M.

CONCLUSION

Dexamethasone as an adjuvant hastens the onset and prolongs the duration of both sensory and motor blocks and reduces postoperative analgesic requirement when compared to midazolam.