Background: Ultrasound guided (USG guided) Erector spinae plane block is a simple, safe regional block being used for carcinoma breast patients posted for Modified Radical Mastectomy(MRM). Nowadays, many adjuvants are added to local anaesthetics to increase the duration of analgesia and make them more effective. As there were no studies on effect of adding dexamethasone as an adjuvant to bupivacaine in erector spinae block in MRM patients, a double blind, randomised controlled study was done in carcinoma breast patients.

Purpose of study was to determine the pain free duration postoperatively. secondary outcome was to study total rescue analgesia requirement in 24 hours, Patient satisfaction score and any other side effects like postoperative nausea and vomiting, bradycardia etc. Seventy ASA 1&2 females , diagnosed with carcinoma Breast and posted for elective MRM surgery in age group of 18-65 years were enrolled.Group 1 patients received Ultrasound guided Erector spinae plane block with 20ml Bupivacaine 0.25% plain and Group 2 patients received 20 ml of Bupivacaine 0.25% with 8mg of injection Dexamethasone.



Results: Group 2 had longer pain free duration (17 ± 6.18 hours) compared to Group 1 (6.97 ± 4.01 hours) (p value=0.0001). In Group 2: Tramadol consumption as rescue analgesia was lesser, lower incidence of Postoperative nausea and vomiting, better patient satisfaction score compared to Group 1. Haemodynamic stability was comparable in both groups.

Conclusions: Adding dexamethasone to local anaesthetics decreases consumption of rescue analgesia or opioids and increases the duration of analgesic effect of ESP block.