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)

Competing Interest Statement

The authors have declared no competing interest.

Clinical Trial

PACTR202509579633417

Funding Statement

The author(s) received no specific funding for this work.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethical clearance and approval were obtained from the Ethical and Scientific Committee of the Orotta College of Medicine and Health Sciences as well as from the Health Research Proposal Review and Ethical Committee of the Ministry of Health. Permission was also granted from Halibet National Referral Hospital. Additionally, the study is registered retrospectively in the Pan African Clinical Trial Registry. This study also fulfills the requirement of any subject protection and does not harm principle of a clinical trial which adheres to the declaration of Helsinki. After the purpose of the study was explained and confidentiality and anonymity was assured, informed written consent was obtained from each participant. Names and other identifying information were not included in the study. All methods were performed in accordance with relevant guidelines and regulations.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request

List of abbreviationsASAAmerican Society of AnesthesiologistsBSBupivacaine and normal salineBDBupivacaine and dexamethasoneCIConfidence IntervalENTEar nose throatDOADuration of actionGIGastrointestinalHNRHHalibet National Referral HospitalIVIntravenousISBInterscalene BlockLAsLocal AnestheticsNRSNumerical Rating ScalePADSSPost-Anesthetic Discharge Scoring SystemPNBPeripheral Nerve BlockPOPPostoperative PainSCBPBSupraclavicular Brachial Plexus BlockSPSSStatistical Package for Social SciencesVASVisual Analog ScaleRCTRandomized Clinical TrialUSGUltrasonography