Ropivacaine is one of the most frequently used local anaesthetic for peripheral nerve blocks. It has the drawback of delayed onset of sensory and motor block. Dexamethasone is a very potent glucocorticoid with very good anti-inflammatory and analgesic activity. In this study we observed, compared and evaluated block characteristics when Ropivacaine alone and ropivacaine with dexamethasone were used for supraclavicular block. A total of 80 adult patients undergoing elective forearm surgery under supraclavicular brachial plexus blockade using nerve stimulator were included in the study. Patients were randomly allocated to the two groups of 40 each. Group A received 30ml of 0.5% ropivacaine with distilled water (2ml). Group B received 30ml of 0.5%ropivacaine with 8mg dexamethasone (2ml). Onset and duration of sensory block, motor block and analgesia were assessed. Data analysed using IBM SPSS Statistics 20.0 software and P < 0.05 was considered as statistically significant. Mean sensory onset time in group A was 4.05 ± 0.678 min and in group B was3.60±.383 min (p <0.05). Mean motor onset time in group A was  5.58±0 .418 min and in group B was 4.75±0.308 min (p <0.05). Mean duration of sensory block in group A was 579.18 ± 111.454 min and in group B was 1174.70±7.690 min (p <0.05). Group A had a mean duration of motor block of 489.38 ± 80.329 min  and 1085.82±36.070 min in group B (p <0.05).Duration of analgesia  of group A  was 647.72 ± 91.743 min and in group B was 1202.00 ±14.881 min (p <0.05).

Conclusion: The study demonstrates that Ropivacaine with dexamethasone as adjuvant produces faster onset and better sensory and motor blockade as well as longer duration of analgesia than with Ropivacaine and distilled water.

Keywords:  Ropivacaine, dexamethasone, supraclavicular brachial plexus block, nerve stimulator, forearm surgery

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Dr Sunil. R

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