May 2025, Volume 3, Issue 5

Author

Shabeel Aboobacker, Brejesh Ravi Varma, Ashitha Koyaparambath and Mohsina Saidalavi

Abstract

Introduction: Postoperative pain management is crucial especially among patients undergoing upper limb surgeries, since multiple systemic analgesics can cause many adverse effects. Regional anesthesia, specifically ultrasound-guided interscalene brachial plexus block serves as effective postoperative analgesia. The duration of a single dose of nerve block is limited and hence, to enhance the quality of analgesia and prolong its duration, adjuvants like dexamethasone are being added. Hence this study was planned to compare the efficacy of 2 mg perineural dexamethasone with 4 mg perineural dexamethasone among those who were planned for shoulder arthroscopy under general anesthesia. Materials and Methods: This study was conducted in a teritiary care hospital in south India among 56 participants who underwent arthroscopic surgery in the shoulder. They were allotted to either 2 mg or 4 mg dexamethasone groups by lottery method and with the help of Ultrasound guided interscalene block, bupivacaine was injected. A structured proforma was used to collect data (sociodemographic, clinical, duration to achieve and maintenance of sensory/motor blockade and hemodynamics). Results: Both groups were ensured to be comparable before the start of the study. The 4mg Dexamethasone group achieved faster motor and sensory blockade and the effect of analgesia was prolonged in the 4mg group compared to the 2 mg group. No significant adverse events was noted between groups. Conclusion: Analgesic effect of 4 mg dexamethasone given perineurally enhances the effectiveness of the interscalene brachial block (onset and duration of motor and sensory block) when compared to 2mg. The safety profile is also favourable. The use of 4 mg dexamethasone is considered a better adjuvant for post operative pain among those undergoing shoulder arthroscopy under regional anesthesia.