Is there a dose response of dexamethasone as adjuvant for supraclavicular brachial plexus nerve block? A prospective randomized double-blinded clinical study

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Eighty-nine patients scheduled to undergo shoulder arthroscopy were randomized to either 1-, 2-, or 4-mg of dexamethasone with bupivacaine or a control group without dexamethasone. The purpose of this study was to determine the analgesic effects of various dosages of dexamethasone in combination with low concentration local anesthetics for use as an adjuvant in supraclavicular brachial plexus nerve block and to determine the lowest dosage needed to provide benefits for perioperative pain relief. The findings demonstrated significant increases in analgesia duration and motor blockade with the addition of dexamethasone, although there were no significant differences between low and high doses dexamethasone when added to 0.25% bupivacaine.