Intravenous Regional Anaesthesia: Lidocaine versus Combination of Lidocaine and Dexamethasone

BACKGROUND: Intravenous regional anaesthesia, though a effective, reliable and safe technique, has its own share of disadvantages. OBJECTIVE: To compare the analgesic efficacy of lidocaine alone versus combination of lidocaine with dexamethasone for intravenous regional anaesthesia. METHODS: A total number of 50 patients of ASA physical status I and II aged 15 to 65 years undergoing ambulatory hand surgery were recruited. 25 patients received 40 ml of 0.5% lidocaine whereas 25 patients received 40 ml of 0.5% lidocaine and 8mg dexamethasone. Onset, duration and recovery times of sensory and motor block, time to request for first analgesic and total analgesic consumption in 24 hours were recorded. RESULTS: The onset and duration of sensory and motor block did not differ significantly amongst the two groups. The recovery time of sensory and motor block was significantly longer in the study group as compared to the control group. The patients in the study group had a significantly longer pain free interval as compared to the control group. The total analgesic consumption in first 24 hours as well as the total number of patients requiring analgesia was significantly lower in the study group as compared to the control group. CONCLUSION: Adding 8 mg dexamethasone to an intravenous regional anaesthesia solution did not shorten sensory and motor block onset time but prolonged sensory and motor block recovery time, besides reducing postoperative analgesic consumption. JMS 2012;15(2):123-27