Background: Brachial plexus block with Bupivacaine provides effective intraoperative anesthesia and analgesia. The use of dexamethasone along with local anesthetic has been shown to improve the duration of analgesia. Objective: To observe the effect of Dexamethasone on the duration of analgesia for Supraclavicular Brachial plexus block. Materials and Methods: A prospective, double-blind study was undertaken in patients scheduled for upper limb surgeries under supraclavicular brachial plexus block. patients were randomly divided into two groups, Group (BD) and B. Group B received 28 ml of 0.25% bupivacaine with 2 ml normal saline while Group BD received 28 ml of 0.25% bupivacain with 2ml (8mg) dexamethasone for supraclavicular brachial plexus block. The groups were compared regarding quality of sensory and motor blockade. All the information was recorded in data collection sheet. Data was processed and analysed with the help of computer program SPSS and Microsoft excel. Results: There was no significant difference between groups in respect of demographic and American Society of Anaesthesiologist (ASA) status. Mean age was found to 34.7±8.53 years. In Group (BD) , 63.3% were ASA I and 36.6% were ASA II. In Group B, 60% were ASA I and 40% were ASA II. It has become evident that satisfactory anaesthesia can be made possible by addition of adjuvant to local anaesthetic in brachial plexus block (in Group-BD). onset of sensory block was faster in Group BD (8.17 ± 1.4 min) than Group B (9.12 ± 1.68 min). Similarly mean onset time of motor block in group A was 12.26 ± 3.96 min, and 11.58 ± 3.68 min in group B. Our study shows that duration of motor block was 408.68±26.96 min and 380.26 ± 24.11 min in group BD and Group B respectively. Conclusion: There was significantly prolonged duration of analgesia in addition of Dexamethasone without any unwanted effects. KYAMC Journal Vol. 11, No.-4, January 2021, Page 199-203

InroductionEpidural administration is a medical route of administration in which a drug or contrast agent injected into the epidural space of the spinal cord. Techniques such as epidural anaesthesia and epidural analgesia employ this route for administration. Epidural techniques frequently involve injection of drugs through a catheter placed into the epidural space. The injection can result in a loss of sensation of pain by blocking the transmission of signals through nerve fibers near the spinal cord. Epidural anaesthesia is a safer technique then SAB (Sub Arachnoid Block) which causes profound hypotension and may cause PDPH (Post Dural Puncture Headache). Post-operative analgesia can also be maintained through epidural catheter. With all adequate aseptic precaution L3-L4 space was identified and marked. 40mg of 2% Lignocaine was infiltred. 18G Epidural (Tuohy) needle was introduced, piercing the skin and subcutaneous tissue, reaching the epidural space and confirmed by the introduction of air through epidural needle, loss of resistance was found. Then epidural catheter was introduced through epidural tuohy needle. A bolus dose of bupivacaine 0.5% (10ml) 50mg with Lignocaine 2% (5ml) 100mg and 50 microgram of fentanyl was given through the epidural catheter. Case Report Abstract