USE of the perfusion index as an objective indicator of the effect of dexamethazone as adjuvant on anesthesia ontime in the supraclavical brachial plexus block

Background and aim: To evaluate the usability of the perfusion index as an objective indicator of the effect of perineural or intravenous use of dexamethasone on the onset of anesthesia in patients undergoing supraclavicular brachial plexus block. Methods: A total of 60 patients, ASA I-III, aged between 18-75 years, who would undergo supraclavicular block were included in our study. The patients were divided into 3 groups of 20 each. Perineural bupivacaine and lidocaine to group A (control group); Group B includes perineural bupivacaine, lidocaine, 8mg dexamethasone; Perineural bupivacaine, lidocaine and 8 mg dexamethasone IV were administered to Group C. The perfusion index was recorded at 2-minute intervals for 20 minutes in the blocked and non-blocked arm. Block onset times, postoperative block and analgesia times, and complications were recorded. Results: In groups A, B, C, respectively; perfusion index median values in the blocked arm were 6 min; (3.7; 4.8; 3.8) 8th min; (4.2; 5.5; 4.5) 10th min; (5.2; 6.0; 5.3) 12th min; (5.7; 6.3; 6.0) were found. The perfusion index of the B group at the specified minutes was higher than the other groups. Motor block onset times (15.0 min; 10.0 min; 12.0 min), sensory block onset times (11.0 min; 9.0 min; 10.0 min) were found. The motor and sensory block start time of group B was shorter. Total duration of motor block (332.5 min; 997.5 min; 742; 5 min) and sensorial block total time (357.5 min; 1032.5 min; 765;0 min) were the longest in group B and the shortest in group A. . The patients' analgesia times (520.0 min; 1245 min; 1005 min) were the longest in group B and the shortest in group A. Conclusion: Addition of perineural dexamethasone in supraclavicular brachial plexus block shortens the onset of anesthesia, and the perfusion index can be used as an objective parameter when evaluating this. Perineural and iv added dexamethasone prolongs the duration of total block and analgesia. Keyword: supraclavicular block, perineural dexamethasone, iv dexamethasone, perfusion index