Brachial Plexus Block For Ambulatory Upper Limb Surgeries: Comparison of the Effects of Nalbuphine Versus Dexamethasone: Prospective, randomized, double-blinded, controlled clinical trial

Abstract

Addition of an adjuvant to local anesthetics improves the quality of nerve block and reduces the need for postoperative opioids intake. The study was aimed to compare the efficiency of dexamethasone versus nalbuphine as perineural additives to local anesthetics mixture in supraclavicular brachial plexus block. The study included 45 patients scheduled for ambulatory upper extremities operations under the supraclavicular brachial plexus block. The patients were allocated to three equal groups (n=15): (i) Group C: patients received 30 mL of local anesthetics (bupivacaine 0.5% + Lidocaine 2% 1:1 mixture) + 2 ml normal saline. (ii) Group D: patients received 30 mL volume of local anesthetics (bupivacaine 0.5% + Lidocaine 2% 1:1 mixture) + 8 mg dexamethasone 0.4% (2 mL). (iii) Group N: patients received 30 mL of (bupivacaine 0.5% + Lidocaine 2% 1:1 mixture) +10 mg nalbuphine HCl (completed to 2 mL with normal saline). We compared the duration of postoperative analgesia, total opioid consumption, and complications in the first 24 hours. Statistically significant prolongation in the duration of analgesia was noticed in group D and group N with the least opioid consumption in group N. Addition of dexamethasone or nalbuphine to lidocaine/bupivacaine mixture can prolong the duration of analgesia and reduce opioids consumption after supraclavicular brachial plexus block.