1*Postgraduate, Department of Anaesthesiology and Critical Care, Sree Balaji Medical College and Hospital, No. 7, CLC Works Road, Chromepet, Chennai - 600044, Tamil Nadu, India; Bharath Institute of Higher Education and Research (BIHER). Email: kavyasri.21798@gmail.com ORCID: https://orcid.org/0009-0007-0107-7826 (Corresponding Author)
2Associate Professor, Department of Anaesthesiology, Sree Balaji Medical College and Hospital, No. 7, CLC Works Road, Chromepet, Chennai - 600044, Tamil Nadu, India; Bharath Institute of Higher Education and Research (BIHER). Email: bhagyavardhan@gmail.com
3Professor, Department of Anaesthesiology, Sree Balaji Medical College and Hospital, No. 7, CLC Works Road, Chromepet, Chennai - 600044, Tamil Nadu, India; Bharath Institute of Higher Education and Research (BIHER). Email: kalamhn@gmail.com
4Professor, Department of Anaesthesiology, Sree Balaji Medical College and Hospital, No. 7, CLC Works Road, Chromepet, Chennai - 600044, Tamil Nadu, India; Bharath Institute of Higher Education and Research (BIHER). Email: dr.vs.md@gmail.com
5Bachelor of Science in Allied Health Sciences (Operation Theatre and Anaesthesia Technology), Department of Anaesthesiology, Sree Balaji Medical College and Hospital, No. 7, CLC Works Road, Chromepet, Chennai - 600044, Tamil Nadu, India; Bharath Institute of Higher Education and Research (BIHER)
Received: 15th Feb, 2026; Revised: 27th Feb 2026; Accepted: 20th Mar, 2026; Available Online: 5th Apr, 2026
Background: Ultrasound-guided supraclavicular brachial plexus block is widely used for upper limb surgeries due to its rapid onset, high success rate, and effective postoperative analgesia. Bupivacaine is commonly used; however, its duration of analgesia may be limited when used alone. The addition of adjuvants such as corticosteroids and opioids has been explored to enhance block characteristics and prolong analgesia.
Objectives: To compare the efficacy of dexamethasone and buprenorphine as adjuvants to 0.5% bupivacaine in terms of sensory and motor block characteristics, duration of postoperative analgesia, haemodynamic stability, and incidence of adverse effects in patients undergoing upper limb surgeries.
Methods: This prospective observational study was conducted in a tertiary care teaching hospital on 60 patients aged 20–45 years (ASA I–II) undergoing elective upper limb surgeries under ultrasound-guided supraclavicular brachial plexus block. Patients were randomly allocated into two groups: Group D received 0.5% bupivacaine with dexamethasone (8 mg), and Group B received 0.5% bupivacaine with buprenorphine (0.3 mg). Primary outcomes included onset and duration of sensory and motor block, and duration of postoperative analgesia assessed using the Visual Analogue Scale (VAS). Secondary outcomes included haemodynamic parameters and adverse effects.
Results: There was no significant difference in onset of sensory block (p = 0.412) or motor block (p = 0.367) between the groups. However, dexamethasone significantly prolonged the duration of sensory block and postoperative analgesia compared to buprenorphine (p = 0.001). The time to first rescue analgesia was significantly longer in Group D (23.4 ± 3.1 hours) compared to Group B (16.8 ± 2.9 hours; p = 0.002). Haemodynamic parameters remained stable with no significant intergroup differences (p > 0.05). The incidence of adverse effects was lower in the dexamethasone group (6.7%) compared to the buprenorphine group (23.3%; p = 0.041).
Conclusion: Dexamethasone is a superior adjuvant to buprenorphine when combined with bupivacaine in ultrasound-guided supraclavicular brachial plexus block. It provides prolonged postoperative analgesia, maintains haemodynamic stability, and is associated with fewer adverse effects, thereby improving overall patient outcomes in upper limb surgeries.
Keywords: Adjuvants, Bupivacaine, Dexamethasone, Buprenorphine, Supraclavicular brachial plexus block, Ultrasound guidance, Postoperative analgesia
How to cite this article: Kavyasri M, Botta B, Kala B, Senthil Kumar VS, Kannan K. A Prospective Observational Study Comparing Dexamethasone Versus Buprenorphine Added to 0.5% Bupivacaine in Brachial Plexus Block. Int J Drug Deliv Technol. 2026;16(4): 29. DOI: 10.25258/ijddt.16.4.4
Source of support: Nil.
Conflict of interest: None