To compare the efficacy of dexamethasone with levobupivacaine versus fentanyl with levobupivacaine on duration of analgesia after supraclavicular brachial plexus blockade

Objective: Supraclavicular brachial plexus block is one of the easiest and the most consistent method for anesthesia and perioperative pain management in surgeries below the shoulder joint. In this randomised control trial, we aimed to compare the analgesic efficacy of 0.5% levobupivacaine with 4mg dexamethasone and 25 mcg fentanyl as adjuvants for brachial plexus block (supraclavicular approach) in upper extremity surgeries. Method: Ninety patients were randomly divided into 3 groups of 30 each. Group L: 25 ml 0.5 %levobupivacaine + Normal Saline 1 ml. Group D: 25 ml 0.5% levobupivacaine + dexamethasone (4 mg). Group F: 25ml 0.5% levobupivacaine + fentanyl (25 mcg). Time of onset of sensory block, time of onset of motor block, duration of motor block and total duration of sensory block were noted. Postop analgesia and VAS score was recorded for 24 hours. Results: Onset of sensory and motor block was 6.10+2.51 min and 11.57+3.19 min in Group D, 9.67+3.61 min and 15.73+3.83 min in Group F, 13.87+3.83 min and 21.57+3.53 min in Group L respectively. Conclusion: Addition of 4mg dexamethasone to 0.5% levobupivacaine for supraclaviclar plexus block shortens sensory, motor block onset time and motor block durations, extends sensory block, and analgesia durations.