The brachial plexus block is commonly performed procedure in anaesthetic practice today. It is used for analgesia as well as anaesthesia in upper limb procedures. This achieves near ideal operative conditions by producing complete muscular relaxation maintaining stable intraoperative haemodynamics and reduces post-operative pain, vasospasm and edema. Bupivacaine 0.5% is one of the most commonly used local anaesthetic agents because of its higher potency and prolonged duration of action. One of the drawbacks of bupivacaine is its cardiotoxicity which is near fatal, especially when injected accidentally into the artery. Levobupivacaine(S-enantiomer of Bupivacaine) local anaesthetic agent as it has a longer duration of action. However it has limiting factors like delayed onset, patchy and incomplete analgesia. Dexamethasone has been studied as an adjuvant to local anaesthetic in peripheral nerve block. Steroids have nerve block prolonging effects by blocking transmission of nociceptive myelinated c-fibres and suppressing ectopic neuronal discharge. They are also thought to alter the function of potassium channels in the excitable cells. Thus, dexamethasone is selected as an adjuvant to local anaesthetic (levobupivacaine) in a study because it has been reported to prolong duration of action of local anaesthetics with no respiratory depression. This in turn will help in titrating the dose of Bupivacaine there by optimizing this technique of analgesia.

Dexamethasone is added to levobupivacaine to improve quality and duration of action thus providing for postoperative analgesia. Some studies suggest that when used as an adjuvant to peripheral nerve block in upper limb surgery, dexamethasone may prolong duration of sensory block and are effective in reducing postoperative pain intensity and opioid consumption.