Comparison of Interscalene Brachial Plexus Block Performed With and Without Steroids

This prospective comparative clinical study was performed to evaluate the effect of triamcinolone when added to bupivacaine during brachial plexus blockade in patients undergoing shoulder surgery. Interscalene brachial plexus blocks were performed on 910 patients before shoulder surgery. Of the patients, 574 were randomly allocated to receive steroids added to the injected local anesthetic and 336 patients received local anesthetic without steroids. All patients were followed prospectively to evaluate the rate of successful anesthesia, duration of anesthesia, side effects of the block, adverse events, and persistent neurologic complications associated with interscalene brachial plexus block. Patients who received steroids had statistically longer pain relief than those who did not receive steroids (P<.001). No difference was found in adverse events, complications, or side effects. Compared with blocks performed without steroids, a statistically longer duration of block analgesia occurred with the addition of steroids to the local anesthetic solution during brachial plexus blockade. Rates of side effects, adverse events, and persistent neurologic complications were similar between the groups.