الفهرس 
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Abstract
TKA is a major surgery where post-operative pain management not only aims for patients comfort but also is crucial to achieve post-operative ambulation leading to better outcome and preventing post-operative complications
FNB is commonly used following TKA for post-operative pain control but affects the quadriceps muscle strength increasing the risk of falls. Meanwhile, ACB has only sensory effect while preserving the motor power allowing for functional recovery within the first 24 hours post‑TKA.
However, single injection nerve block is limited by its short duration. Adding adjuvants to the local anesthetic has shown prominent results in prolongation of the duration of the nerve block with dexamethasone being the most effective one.
The aim of the study is to assess the efficacy of perineural dexamethasone as an adjuvant on duration of sensory blockage of Saphenous nerve block - performed by levobupivacaine -after knee arthroplasty surgery.
The study was conducted on 40 random patients who were scheduled to undergo unilateral total knee arthroplasty and where divided into 2 equal groups:
• group A: patients received spinal anaesthesia followed by ACB with 19ml levobupivacaine plus 1ml normal saline.
• group B: patients received spinal anesthesia followed by ACB with 19ml levobupivacaine injection plus 1ml (4mg) dexamethasone.
The two groups were adequately monitored and assessed post-operatively for 24 hours and they were compared regarding analgesic outcome by recording time for first for analgesic need, total consumption of opioid and pain score during walking and climbing stairs. Side effects were also monitored and compared.
The results of the study revealed, prolongation of ACB when adding dexamethasone perineurally as an adjuvant to levobupivacaine. Evident by prolongation of time for first analgesic requirement, decrease in total consumption of opioid in first 24 hours and lower pain score during walking and climbing stairs.