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BACKGROUND: In an attempt to improve the recovery and early rehabilitation after thoracotomy, various methods of pain-relief have been tried to prolong the duration and to improve the quality of postoperative analgesia. Paravertebral block using steroids like dexamethasone, administered as an adjuvant along with local anaesthetic agents, could be of particular interest. METHODS: Fifty patients undergoing elective thoracotomy were randomly assigned to one of the following groups containing twenty five patients each. Group D patients received 8 mg (2 ml) of dexamethasone added to 18 ml of 0.25% levobupivacaine as paravertebral block (total volume 20 ml). Group L patients received 18 ml of 0.25% levobupivacaine and 2 ml of isotonic saline (20 ml in total) as paravertebral block. Analgesic effect was evaluated by measuring pain intensity (VAS score) and duration of analgesia. RESULTS: A longer delay was observed between paravertevral block with study medication and first requirement of supplementary analgesic in group D (602.24±78.72 minutes) compared to group L (410.48±56.64 minutes). Total consumption of diclofenac sodium in first 24 hours in postoperative period was significantly less in group D. No significant side effects were noted. CONCLUSION: Dexamethasone, used as adjuncts to levobupivacaine for thoracic paravertebral block in patients undergoing thoracotomy, improve the quality and prolong the duration of post operative analgesia.

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