Yes i used to do it . But i found that Mgso4 is more effective and provide you more block time .

Dear Wael,

What about analgesic effect? What does you give?

Thanks 

Yes. 4mg dexamethasone. Sometimes ketamine 20mg (in combination w/ dexamethasone or instead of).

Current evidence suggests that dexamethasone will prolong the duration of peripheral nerve blocks and this effect is greater if dexamethasone is added to the block solution (i.e. delivered perineurally) compared with IV administration, though both are effective.

A recent meta-analysis by Chong et al. found the following:

"RESULTS

Eleven RCTs met the inclusion criteria with a total of 1076 subjects. Perineural dexamethasone prolonged the duration of analgesia by 3.77 hours (95% confidence interval [CI], 1.87-5.68 hours; P < 0.001) compared to IV dexamethasone, with high statistical heterogeneity. For secondary outcomes, perineural dexamethasone prolonged the duration of both motor (3.47 hours [95% CI, 1.49-5.45]; P < 0.001) and sensory (2.28 hours [95% CI, 0.38-4.17]; P = 0.019) block compared to IV administration. Furthermore, perineural dexamethasone patients consumed slightly less oral opioids at 24 hours than IV dexamethasone patients (7.1 mg of oral morphine equivalents [95% CI, 0.74-13.5 mg]; P = 0.029), and there were no statistically significant differences in the other secondary outcomes. Notably, no increase in adverse events was detected.

CONCLUSIONS

Perineural dexamethasone prolongs the duration of analgesia across the RCTs included in our meta-analysis. The magnitude of effect of 3.77 hours raises the question as to whether perineural dexamethasone should be administered routinely over its IV counterpart-or reserved for selected patients where such prolongation would be clinically important."

https://www.ncbi.nlm.nih.gov/pubmed/28252523

Studies shows that both have almost similar efficiency. But on addition of dexamethasone in peripheral nerve block prolongation of motor block is observed....