DOI: https://doi.org/10.36347/sasjs.2025.v11i01.008

Pages: 37-42

Background: Brachial plexus block is a widely used regional anesthesia technique for upper limb surgeries. Multidrug regimens incorporating lidocaine, bupivacaine, and dexamethasone aim to enhance block efficacy while maintaining safety. This study evaluates the comparative efficacy and safety of three brachial plexus block regimens using lidocaine, bupivacaine, and dexamethasone in patients undergoing upper limb surgeries. Methods: A retrospective cohort study was conducted involving 150 patients undergoing upper limb surgeries. Block efficacy was assessed through the onset and duration of sensory and motor blockades, along with pain scores using the Visual Analog Scale (VAS). Safety outcomes were determined by analyzing the incidence of adverse effects, including nausea, vomiting, hypotension, bradycardia, and local anesthetic systemic toxicity (LAST). Comparative analyses among groups were performed using appropriate statistical tests. Results: Group C (lidocaine + bupivacaine + dexamethasone) demonstrated the shortest onset times for sensory (5.6 ± 1.1 min) and motor (7.5 ± 1.2 min) blocks and the longest block durations for sensory (15.8 ± 2.2 hours) and motor (14.5 ± 2.1 hours) blocks compared to Groups A and B (p < 0.001). Pain scores at 6 and 24 hours were significantly lower in Group C (VAS 1.5 ± 0.7 and 3.8 ± 1.1, respectively; p < 0.001). Safety outcomes were comparable across groups, with a low incidence of adverse effects and no cases of LAST. Conclusion: The combination of lidocaine, bupivacaine, and dexamethasone in a brachial plexus block significantly improves block efficacy and duration while maintaining a favorable safety profile. This multidrug regimen holds promise for optimizing perioperative outcomes in upper limb surgeries, warranting further prospective studies for validation.