The effect of intravenous dexamethasone in supraclavicular brachial plexus block at Halibet National Referral Hospital, Eritrea 2024–2025: A randomized clinical trial

Abstract

Abstract Background Postoperative pain significantly impacts recovery and healthcare costs. Supraclavicular brachial plexus block (SCBPB) offers effective regional anesthesia but has limited duration. However, dexamethasone may enhance and prolong analgesia when used as an adjunct. Therefore, this study aimed to evaluate the effective of dexamethasone added to bupivacaine in prolonging postoperative analgesia. Method A randomized clinical trial was conducted at Halibet National Referral Hospital, Eritrea, involving 60 patients undergoing upper limb surgery. Group A received 0.5% bupivacaine (20 ml) with 2 ml normal saline; Group B received 0.5% bupivacaine (20 ml) with 2 ml (8 mg) intravenous dexamethasone. Pain scores, time to first rescue analgesia, and analgesic consumption were recorded. Data were analyzed using SPSS v26. Results The mean duration of analgesia was significantly longer in the dexamethasone group (17.36 ± 3.75 hours) compared to the control group (7.57 ± 1.04 hours, p < 0.001). The dexamethasone group had faster onset of sensory and motor block and lower analgesic consumption. Conclusions The addition of 8 mg intravenous dexamethasone to 0.5% bupivacaine in supraclavicular brachial plexus blocks significantly prolonged postoperative analgesia, accelerated the onset of sensory and motor block, and reduced analgesic consumption. This combination offers a safe, effective, and practical enhancement to regional anesthesia for upper limb surgeries. Trial registration PACTR202509579633417 (retrospectively registered on 11 September 2025)