Prospective Randomized Controlled Study Evaluating the Effect of Adding Dexamethasone to Bupivacaine on Adductor Canal Block Outcomes in Patients Undergoing Arthroscopic Anterior Cruciate Ligament Reconstruction

Abstract
Background: Adductor canal block is a new analgesic technique with fast functional recovery and good pain control, and it is predominantly a sensory block. Recent studies indicate that perineural dexamethasone increase the duration of pe-ripheral nerve block analgesia.
Aim of Study: To evaluate the effect of adding dexameth-asone to bupivacaine on the quality and duration of adductor canal block in patients undergoing arthroscopic anterior cruciate ligament reconstruction under general anaesthesia with visual analogue scale as primary outcome, total amount of morphine consumption and any reported side effects as secondary outcomes.
Material and Methods: Sixty adults (ages 18-60) scheduled for arthroscopic anterior cruciate ligament reconstruction under general anesthesia. Patients were classified into two equal groups each of 30 patients. Patients of group I received 15ml 0.5% bupivacaine plus perineural 2 ml saline and patients of group II received 15ml 0.5% bupivacaine plus perineural dexamethasone 8mg/2mL. pain scores, block duration, opioid consumption and time to first rescue analgesia were measured. Any undesirable side effects were recorded.
Results: In the present study, sensory block duration was prolongated in group II. In POD (postoperative day) 2 morphine consumption was less in group II. Time till first rescue analgesia was given was significantly shorter in group I than group II.
Conclusions: Adductor canal bock provides excellent analgesia after ACL reconstruction under general anaesthesia. Moreover, Dexamethasone when added to bupivacaine in adductor canal block is associated with significant prolongation of sensory block and significant decrease in total opioid consumption.