الفهرس 
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Abstract
Summary
Supraclavicular brachial plexus block is widely employed regional nerve block to provide anaesthesia and analgesia for the upper extremity surgery. Supraclavicular block provides a rapid, dense and predictable anesthesia of the entire upper extremity.
This study evaluated the effect of adding dexmedetomidine, dexamethasone or lornoxicam as an adjuvant to bupivacaine in supra- clavicular brachial plexus block on the onset time and the duration of sensory and motor blocks and duration of analgesia and side effects such as hypotension , bradycardia, nausea, vomiting, and hypoxemia.
This study enrolled 112 co-operative ASA physical status I & II patients of both sex aged 18-60 years undergoing elective surgery of arm, elbow or forearm.
Patients were randomly assigned into four equal groups by sequentially numbered opaque sealed envelope dexamethasone, dexmedetomidine and lornoxicam are used as an adjuvant to bupivacaine in the first three groups and bupivacaine was used alone in the last group as a control group.
Comparison between all groups revealed rapid onset of sensory block, motor block and prolonged duration of analgesia when these adjuvants are added to bupivacaine than bupivacaine alone and dexamethasone is the best in this concern as compared to other groups.
Limitations of this study: this study needs to be explored in a larger study population and in different nerve blocks. And needs to be explored on a small volume local anesthetic to determine minimum effective local anesthetic volume.