IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 17, Issue 9 Ver. 7 (September. 2018), PP 41-44 www.iosrjournals.org DOI: 10.9790/0853-1709074144 www.iosrjournals.org 41 | Page Evaluation of Post Operative Analgesia on Adding Dexamethasone with Ropivacaine in Interscalene Brachial Plexus Block for Shoulder Surgery Deeksha Bindal 1 , *Varun Kumar Saini 2 , Gaurav Sharma 3 1,2,3 Department of anesthesiology and critical care, Rajasthan University of health sciences Medical College and Hospital, Jaipur, Rajasthan, India *Corresponding author: Varun Kumar Saini Abstract : Background and Objectives: Dexamethasone as an adjuvant to ropivacaine for interscalene brachial plexus (ISBP) block prolongs duration of analgesia . However, this study was conducted to further substantiate analgesic efficacy of dexamethasone as an adjuvant to ropivacaine in ISBP block for shoulder surgeries.Methods :After taking hospital ethical clearance and written informed consent from patients,nerve stimulator guided ISBP block was given to 100 patients , randomly assigned to one of two groups: (N=50 in each group). Group R (ropivacaine ) received 30 ml (0.5%) ropivacaine + 2 ml saline and group RD ( ropivacaine – dexamethasone ) received 30 ml (0.5%) ropivacaine + dexamethasone 8 mg . Duration of analgesia, onset of sensory and motor block, VAS score, 24 hour analgesic requirement were recorded and compared. Computer software SPSS version‑ 16 (SPSS Inc., Chicago, Illinois, USA) was used for statistical analysis. Chi‑ square test and Student’s t‑ test were used and P < 0.05 was considered as significant. Results: The mean duration of analgesia in Group RD was 1211.83±32.86 min and in Group R it was 283.17.±7.71 min (P = 0.0001). Onset of sensory block in Group RD was 9.27±0.980 min and in Group R was 16.00±1.438 min (p <0. 001) Onset of motor block in Group RD was 14.07±1.929 min and in Group R was 20.27±1.799min (P = 0.2244). Conclusion: Dexamethasone, when added as an adjuvant to ropivacaine during ISBP block, significantly prolonged duration of analgesia and shortened the onset of sensory and motor block. It provided prolonged post-operative pain relief and hence reduced the number of rescue analgesics required in first 24 hours. Keywords: Bupivacaine ,Dexamethasone, Interscalene brachial plexus block , Ropivacaine. --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 02-09-2018 Date of acceptance: 18-09-2018 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction Pain after orthopedic surgery is intense and unbearable [1] . Managing such pain is challenging. Particularly, in shoulder procedures, where early mobilization is integral part for success of surgery [2] , perfect plan for intra and post-operative pain management should be ready. In our institution, regional anesthesia in the form of an interscalene approach to the brachial plexus is often used for such procedures. But, we found, the analgesic effect of single shot ISBP block with local anesthetics (LA) alone is short-lived and lasted only till early post-operative period. Various adjuvants are added to LA to prolong post-operative analgesia. Dexamethasone a corticosteroid, is one such adjuvant, when added to LA solution, improves post-operative analgesia. It has highly potent anti-inflammatory property without mineralocorticoid activity and is also found to be safer and devoid of potential side effects. Studies have proved analgesic efficacy of dexamethasone with many LA’s like lignocaine, bupivacaine, mepivacaine but only a handful studies have been done using ropivacaine. So, we conducted a randomized controlled trial to study analgesic efficacy of dexamethasone with ropivacaine in ISBP block. The primary aim of the present study was to determine whether dexamethasone (8 mg) as adjuvant to ropivacaine in ISBP would prolong duration of analgesia. Secondary outcome measures were onset of sensory and motor block, median pain scores by using visual analogue scale score (VAS), analgesic consumption in 24 h and blood sugar levels and hemodynamic parameters. II. Subjects And Methods A randomized prospective study was conducted in a tertiary care hospital from January 2018 to June 2018.Institutional ethics committee approval and written informed consent was obtained. 112 patients of either gender, in the age group of 18–70 years, weight ranging between 50 and 70 kg belonging to American Society of Anesthesiologists Grade 1 and 2 posted for elective surgeries on elbow, forearm, and hand were enrolled for the study. Patients who refused to give informed consent, obese and short ‑ neck patients, patients with