The effect of two perioperative dexamethasone regimens on duration of analgesia after upper limb surgery under supraclavicular brachial plexus block: A randomized-controlled study
Akshay Sharma, V. Vimalnathan, Shweta Dhiman, Anju Bhalotra, Rahil Singh, Mona Arya
Department of Anaesthesia and Critical Care, Maulana Azad Medical College, New Delhi, India
Keywords: Intravenous dexamethasone, oral dexamethasone, pain score, postoperative analgesia, supraclavicular brachial plexus block.
Abstract
Background: This study aims to compare the effects of two perioperative dexamethasone regimens on duration of analgesia after upper limb surgery under supraclavicular brachial plexus block (SBPB).
Patients and Methods: Between October 2024 and August 2025, this double-blind, randomized-controlled study included a total of 48 patients who were in the American Society of Anesthesiologists (ASA) Class I-III and underwent elective unilateral osseous surgery of the forearm or hand under ultrasound-guided SBPB with 30 mL of 0.5% ropivacaine. The patients were randomized in 1:1 ratio to oral dexamethasone (OD) group to receive 12 mg OD 2 h before the block and intravenous dexamethasone (ID) group to receive 8 mg of ID at the time of block. The primary outcome was the duration of analgesia. Secondary outcomes included duration of motor block, pain scores at 6, 12 and 24 h, additional postoperative analgesic consumption over the first 24 h and the Quality of Recovery-15 (QoR-15) at 24 h.
Results: Of the patients, 31 were male and 17 were female with a mean age of 34.31 ± 14.15 (range, 18 to 60) years. The mean duration of analgesia was 10.50 ± 3.30 h in group OD and 14.92 ± 3.40 h in group ID (p < 0.001). The mean duration of motor block was 9.33 ± 3.12 h in group OD and 12.75 ± 3.40 h in group ID (p = 0.001). Pain scores at 6, 12 and 24 h after surgery and additional analgesic requirements were higher in group OD (p < 0.001). The QoR-15 scores were higher in group ID at 24 h (p < 0.001).
Conclusion: These findings indicate that the ID regimen in SBPB with ropivacaine resulted in prolonged analgesia and motor blockade, lower pain scores, reduced analgesic consumption, and improved quality of recovery compared to the OD regimen.
Cite this article as: Sharma A, Vimalnathan V, Dhiman S, Bhalotra A, Singh R, Arya M. The effect of two perioperative dexamethasone regimens on duration of analgesia after upper limb surgery under supraclavicular brachial plexus block: A randomized-controlled study. Agri 2026;38(4):226-236. doi: 10.5606/agri.2026.90.