Michael Beraki Mengistu, Senay Amare Habtu, Abel Mussie Elias, Sabrina Hashim Idris, Kisanet Huruy Abraha
In summary, intravenous dexamethasone significantly prolonged postoperative analgesia, accelerated block onset, and reduced analgesic consumption without adverse events. These findings support its use as a practical adjunct to bupivacaine in supraclavicular brachial plexus block, with potential to improve postoperative pain management in low‑resource settings.
BACKGROUND: Postoperative pain has significant impact on recovery and healthcare costs. While effective regional anesthesia provides both anesthesia and analgesia, its effects are often of limited duration. Previous studies indicate that intravenous dexamethasone may enhance and prolong analgesia when used with regional blocks, yet reports on its duration to supraclavicular brachial plexus block (SCBPB) for upper limb surgeries are limited. We hypothesized that intravenous dexamethasone would extend postoperative analgesia following SCBPB.
METHOD: A randomized clinical trial was conducted at Halibet National Referral Hospital in Eritrea, involving 60 patients undergoing upper limb surgery who received SCBPB with 20 ml of 0.5% bupivacaine. Concurrently, the control group received 2 ml of normal saline, while the experimental group received 2 ml (8 mg) of intravenous dexamethasone. Pain scores, time to first rescue analgesia, and analgesic consumption were recorded. Data were analyzed using SPSS v26.
RESULTS: The mean duration of analgesia was significantly longer in the dexamethasone group (17.36 ± 3.75 hours) compared to the control group (7.57 ± 1.04 hours, p < 0.001). The dexamethasone group had faster onset of sensory and motor block and lower analgesic consumption.
CONCLUSIONS: In summary, intravenous dexamethasone significantly prolonged postoperative analgesia, accelerated block onset, and reduced analgesic consumption without adverse events. These findings support its use as a practical adjunct to bupivacaine in supraclavicular brachial plexus block, with potential to improve postoperative pain management in low‑resource settings.
CLINICAL TRIAL REGISTRATION: This trial was registered in the Pan African Clinical Trial Registry (PACTR202509579633417). Participant recruitment occurred between September 23, 2024 and January 17, 2025, with follow‑up completed by January 18, 2025. The authors confirm that all ongoing and related trials for this intervention are registered.