Effect Of Different Doses Of Dexamethasone As Adjuvant On Brachial Plexus Block

Objective:To observe the effect of different doses of dexamethasone as adjuvant on brachial plexus block.Methods:In this study,63 patients who underwent unilateral upper extremity surgery in the second department of the first hospital of Jilin University,ASA grade ?~? were selected,all of these patients were randomly divided into three groups: group A(n = 21),group B(n = 21),and group C(n = 21).Exclusion of patients with incomplete nerve block and lost to follow up.Finally,19 patients were included in group A,20 patients were included in group B and 21 patients were included in group C.All the patients in the three groups were anesthetized by intravenous anesthesia and axillary brachial plexus block under the guidance of ultrasound.In group A,1 mg dexamethasone was added into the mixture of local anesthetics,in group B,3 mg dexamethasone was added into the mixture of local anesthetics,and in group C,5 mg dexamethasone was added into the mixture of local anesthetics.30 minutes after the completion of nerve block,propofol 4-10 mg / kg.h was pumped.The blood pressure(BP),heart rate(HR)and blood oxygen saturation(SpO2)were measuredduring the operation.The heart rate(HR)and mean arterial pressure(map)were recorded before block,10 minutes after block and 30 minutes after block.The time of onset of sensory block(T1),time of onset of motor block(T2),time of duration of sensory block(T3)and time of duration of motor block(T4)were recorded.The NRS pain scores of patients at 6h,12 h and 24 h after operation,the occurrence of adverse reactions within24 h after operation and the satisfaction of anesthesia effect were recorded.Result:There was no significant difference in the onset time of sensory block(T1)and motor block(T2)between the three groups(P > 0.05),and the duration of sensory block(T3)and motor block(T4)in group C was significantly longer than that in group A and B,There was no significant difference in the NRS scores of the three groups at 6h after operation(P >0.05).At 12 h and 24 h after operation,the NRS scores of the patients in group B and group C were lower than those in group A(P < 0.05),and there was no significant difference in the adverse reactions within 24 hours after operation between the three groups(P > 0.05).In addition,the satisfaction of group C with anesthesia was higher than that of group A and group B,the difference was statistically significant(P < 0.05).Conclusion:Under the condition of this study,adding 5 mg dexamethasone tolocal anesthetics during brachial plexus block can produce longer duration of analgesia,effectively reduce the early postoperative pain of patients in the surgical area,and produce better anesthesia effect.