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Abstract
The benefit of adjuvant dexamethasone in regional anesthesia has recently been the focus of investigation as clinical reports suggest improved block characteristics, although its use remains off label and few large randomized controlled trials concerning its use have been completed. The goal of this study is to evaluate whether perineural administration of dexamethasone is more effective in prolonging the duration of lumbar plexus block than giving it systemically. 60 (out of 72) patients were recruited to undergo arthroscopic knee surgery using LPB, 12 patients were excluded from this study as they showed failure of the block that was considered when failure of sensory block for 30 min after block application. Those patients were divided randomly into 3 groups, 20 patients each; group L (LPB with bupivacaine 0.5%), group D (LPB with bupivacaine 0.5% + 8mg dexamethasone perineuraly) and group S (LPB with bupivacaine 0.5% + 8mg dexamethasone intravenously), keeping in mind not to exceed the maximum recommended toxic dose of bupivacaine (2 mg / kg). A standardized telephone call 48 hrs postoperative was done just to evaluate residual pain and functional outcome