Introduction Peripheral nerve blocks for perioperative and postoperative analgesia in pediatric surgery has become increasingly popular in recent years. Thanks to ultrasound guidance, supraclavicular block has regained its popularity since the incidence of complications (pneumothorax) has decreased. Adjuvants are used in order to prolong the duration of peripheral nerve block, and also for limiting the cumulative dose of local anesthetics.

Aim To observe the effect of dexamethasone as adjuvants to local anesthetics in peripheral nerve block in pediatric patients.

Methods The study included 80 patients in the aged group 4–14 years admitted for surgical treatment of upper limb fracture in the period from January 2020 till March 2022. Patients were randomized in two groups. Patients in group 1 (40 patients) received supraclavicular or interscalene block with 2 ml lidocaine 2% and bupivacaine 0.25% (max 2mg/kg) with a total volume of 0.5 ml/kg. In group 2, patients (40) received supraclavicular or interscalene block with 2% lidocaine 2 ml and 0.25% bupivacaine (max 2mg/kg) in combination with 2mg dexamethasone with a total volume of 0.5 ml/kg.

Results The duration of the sensory and motor block was significantly longer in group 2 compared with the first group and also the total number of postoperative doses of analgesia was lower.

Conclusions Dexamethasone is acceptable adjuvant that prolong the duration of action of local anesthetics and thus reduce the need for analgesics in the postoperative period.