Comparative Efficacy of Dexamethasone Plus Bupivacaine versus Bupivacaine Alone in Ultrasound-Guided Supraclavicular Brachial Plexus Block for Upper Limb Surgeries: A Prospective Non-Randomized Controlled Clinical Trial.

Dr. Suryakumari  Malothu; Dr. Pannati Sireesh   Kumar; Dr. G. Shravan   Kumar; Dr. K. Sunil  Kumar

doi:10.51168/sjhrafrica.v7i3.2540

Authors

Dr. Suryakumari Malothu Assistant Professor, Department of Anaesthesiology, Government Medical College/Government General Hospital, Mahabubabad, Telangana 506101, India.
Dr. Pannati Sireesh Kumar Assistant Professor, Department of Anaesthesiology, Government Medical College/Government General Hospital, Mahabubabad, Telangana 506101, India.
Dr. G. Shravan Kumar Professor, Department of Anaesthesiology, Government Medical College/Government General Hospital, Mahabubabad, Telangana 506101, India
Dr. K. Sunil Kumar Professor, Department of Anaesthesiology, Government Medical College/Government General Hospital, Mahabubabad, Telangana 506101, India.

DOI:

https://doi.org/10.51168/sjhrafrica.v7i3.2540

Keywords:

bupivacaine, dexamethasone, supraclavicular brachial plexus block, ultrasound guidance, upper limb surgery

Abstract

Background:

Ultrasound-guided supraclavicular brachial plexus block is a dependable technique for upper limb surgery and offers airway-sparing anesthesia. Because plain bupivacaine provides limited postoperative analgesia, adjuncts that hasten onset and prolong block duration remain clinically relevant.

Objectives:

To compare the onset and duration of sensory and motor block produced by 0.5% bupivacaine with 4 mg dexamethasone versus 0.5% bupivacaine alone for supraclavicular brachial plexus block.

Methods:

This prospective comparative clinical study enrolled 60 patients aged 15-70 years with ASA physical status I/II undergoing elbow, forearm, hand, or finger surgery. Patients received an ultrasound-guided supraclavicular block with 24 mL of 0.5% isobaric bupivacaine plus 1 mL dexamethasone (Group D) or 1 mL normal saline (Group P). One patient in Group P dropped out, leaving 30 and 29 patients for analysis. Sensory onset, motor onset, recovery times, surgery duration, and perioperative complications were recorded.

Results:

Group D showed significantly faster sensory onset (3.23 ± 1.28 vs 8.21 ± 2.58 min) and motor onset (6.23 ± 2.31 vs 13.55 ± 2.85 min). Motor recovery (19.73 ± 5.21 vs 6.03 ± 1.23 h) and sensory recovery (23.38 ± 5.99 vs 6.88 ± 1.22 h) were markedly prolonged in Group D; all comparisons were statistically significant. Surgery duration was similar between groups. No drug-related, hemodynamic, neurologic, or procedural complications were documented; one patient in Group P required midazolam for intraoperative anxiety.

Conclusion:

Perineural dexamethasone added to bupivacaine improved block quality by accelerating onset and prolonging sensory and motor blockade in ultrasound-guided supraclavicular brachial plexus block.

Recommendations:

This combination can be considered for upper limb procedures when prolonged postoperative analgesia is desirable, provided patient selection, sterile technique, and postoperative monitoring are maintained.

Author Biographies

Dr. Suryakumari Malothu, Assistant Professor, Department of Anaesthesiology, Government Medical College/Government General Hospital, Mahabubabad, Telangana 506101, India.

is an Assistant Professor in the Department of Anesthesiology at Government Medical College and Government General Hospital, Mahabubabad. She completed her MBBS from Gandhi Medical College, Diploma in Anesthesiology from Osmania Medical College, and MD in Anesthesiology from Mamata Medical College. She previously served as a Civil Assistant Surgeon Specialist in Anesthesiology and has clinical interests in regional anaesthesia, ultrasound-guided nerve blocks, airway management, and perioperative critical care. ORCID iD: https://orcid.org/0009-0002-5071-2199

Dr. Pannati Sireesh Kumar, Assistant Professor, Department of Anaesthesiology, Government Medical College/Government General Hospital, Mahabubabad, Telangana 506101, India.

is an Assistant Professor in the Department of Anaesthesia at Government Medical College/Government General Hospital, Mahabubabad. He completed his MBBS from Deccan College of Medical Sciences, Hyderabad, in 2008 and MD in Anaesthesiology from SVS Medical College, Mahabubnagar, in 2014. He also served as Senior Resident at Osmania Medical College, Hyderabad, and has two publications to his credit.

Dr. G. Shravan Kumar, Professor, Department of Anaesthesiology, Government Medical College/Government General Hospital, Mahabubabad, Telangana 506101, India

is Professor of Anaesthesia at Government Medical College, Mahabubabad. He completed his MBBS from B.L.D.E.A.’s Medical College, Bijapur, Karnataka, Diploma in Anaesthesia from Kakatiya Medical College, Warangal, and MD in Anaesthesiology from NIMS, Hyderabad. He has served in academic anaesthesia as Assistant Professor, Associate Professor, and Professor, with extensive teaching and clinical experience.

Dr. K. Sunil Kumar, Professor, Department of Anaesthesiology, Government Medical College/Government General Hospital, Mahabubabad, Telangana 506101, India.

is Professor of Anaesthesia at Government Medical College, Mahabubabad. He completed his MBBS and MD in Anaesthesiology from Osmania Medical College, Hyderabad. He has extensive academic and clinical experience in anaesthesia, having served as Assistant Professor and Associate Professor at CKM, Warangal, before joining as Professor at Government Medical College, Mahabubabad.

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