Aim of the study: The study aimed to optimize the quality and duration of analgesia while preserving early recovery of motor function after brachial plexus block. Patients and methods: The study included 90 patients scheduled for elective upper limb surgeries using US-guided supraclavicular brachial plexus block. The patients were allocated randomly into three equal groups (n=30): (i) Group C: 30 ml bupivacaine 0.25%+2 ml 0.9% saline. (ii) Group B: 30 ml bupivacaine 0.5% +2 ml 0.9% saline. (iii) Group M: 30 ml bupivacaine 0.25%+" 4 mg dexamethasone + 10 mg nalbuphine hydrochloride (completed to 2 ml with 0.9% normal saline)". We compared the duration of postoperative analgesia along with motor block duration, opioid consumption, and complications in the first 24 hours. Results: Statistically significant prolongation in the duration of analgesia was noticed in group M with the least opioid consumption compared to group C, also motor block was resolved early in group M compared to group B. Conclusion: Combination of dexamethasone and nalbuphine to bupivacaine 0.25% can prolong the duration of analgesia while preserving the motor function after brachial plexus block.
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