Introduction: perineural dexamethasone prolongs the duration of a single injection peripheral nerve block when added to the local anesthetic solution while perineural use of dexamethasone remains off-label. Postulated systemic mechanisms of action along with safety concerns have prompted the investigation of intravenous dexamethasone as an alternative.

Aim: We aimed to confirm that the addition of intravenous dexamethasone will prolong the duration of analgesia after a single-shot axillary brachial plexus block compared to conventional long-acting local anesthetic alone.

Material And Method: 46 Asa I to III adult patients scheduled for elective forearm and hand surgeries were randomly allocated to 2 groups of 23 patients each. Patients in group D received axillary brachial plexus block with an injection of 30 ml bupivacaine 0.5% and 2 ml of dexamethasone (8mg) IV and Patients in control group A received axillary brachial plexus block with an injection of 30 ml of bupivacaine 0.5% and 2ml of 0.9% saline IV prior to surgery.

Results: There was a statistically significant difference in the duration of post-operative analgesia, duration of motor and sensory blockade, and better overall patient satisfaction in group D when compared to group A.

Conclusion: We concluded that a Single axillary brachial plexus block with 0.5% bupivacaine and intravenous dexamethasone resulted in prolonged duration of postoperative analgesia, sensory and motor blockade, and better patient satisfaction