Postoperative pain substantially affects recovery and resource use. Regional anesthetic techniques such as the supraclavicular brachial plexus block (SCBPB) provide both anesthesia and postoperative analgesia for upper limb surgery, but their duration is often limited. Prior reports have suggested that systemic corticosteroids given intravenously can extend the analgesic effect of regional blocks, but data specific to SCBPB are limited. The authors tested the hypothesis that a single intravenous dose of dexamethasone would extend postoperative analgesia when combined with SCBPB using bupivacaine.
This study was a randomized clinical trial carried out at Halibet National Referral Hospital, Eritrea. Sixty adult patients scheduled for upper limb surgery received a supraclavicular brachial plexus block with 20 ml of 0.5% bupivacaine. Participants were randomized to one of two groups: the control group received 2 ml of normal saline intravenously, while the experimental group received 2 ml (8 mg) of intravenous dexamethasone concurrently with the block. The abstract reports that pain scores, time to first rescue analgesia, and postoperative analgesic consumption were recorded. Data analysis was performed using SPSS v26.
The trial captured both onset characteristics of the block (sensory and motor) and postoperative analgesic outcomes. The key efficacy endpoint reported in the abstract was the mean duration of analgesia, operationalized as time to first rescue analgesia. Secondary outcomes included onset times for sensory and motor block and total postoperative analgesic consumption. The statistical comparison between groups used conventional hypothesis testing, with at least one p value reported (p < 0.001 for the primary comparison). The abstract does not specify additional statistical methods, sample-size calculation, or handling of missing data.
The mean duration of analgesia (time to first request for rescue analgesia) was significantly longer in the dexamethasone group: 17.36 ± 3.75 hours, compared with 7.57 ± 1.04 hours in the control group (p < 0.001). The group receiving intravenous dexamethasone also demonstrated a faster onset of both sensory and motor block. In addition, the dexamethasone arm had lower postoperative analgesic consumption. These findings are reported in the abstract without additional subgroup data or pain-score time courses.
According to the abstract, no adverse events were reported in the trial. The authors state that dexamethasone extended analgesia, accelerated block onset, and reduced analgesic consumption without adverse events. The abstract does not provide detailed safety monitoring methods, specific adverse-event definitions, or duration of safety follow-up beyond the reported postoperative period.
The trial was registered in the Pan African Clinical Trial Registry under PACTR202509579633417. Participant recruitment occurred between September 23, 2024, and January 17, 2025, with follow-up completed by January 18, 2025. The authors declared no competing interests. The full article citation is provided (PLoS One. 2026 Sep 3;21(9):e0338067; doi: 10.1371/journal.pone.0338067), and the report is available under a Creative Commons licence.
In this randomized trial of adults undergoing upper limb surgery with SCBPB using 20 ml of 0.5% bupivacaine, a single 8 mg intravenous dose of dexamethasone given at the time of block was associated with a clinically and statistically significant prolongation of analgesia (mean ~17.4 hours vs ~7.6 hours), more rapid onset of sensory and motor blockade, and reduced postoperative analgesic consumption. The authors conclude that intravenous dexamethasone is a practical adjunct to bupivacaine for SCBPB and highlight its potential usefulness in low‑resource settings where prolonged postoperative analgesia can reduce resource needs.
The abstract provides key outcome results but omits several trial details required for full appraisal. The PubMed abstract does not report the randomization method or allocation concealment, blinding procedures, exact pain-score instruments and time points, sample‑size justification, or comprehensive adverse-event definitions and monitoring. Those methodological details and full numerical results beyond the summarized means and standard deviations would need to be consulted in the full text for a complete assessment.
This randomized clinical trial reported that 8 mg intravenous dexamethasone given with SCBPB using bupivacaine significantly prolonged time to first rescue analgesia, sped block onset, and decreased analgesic consumption without reported adverse events. Trial registration and recruitment dates are provided. Methodologic specifics and expanded safety data were not reported in the abstract and should be reviewed in the complete publication for clinical implementation decisions.