56 patients scheduled for major hindfoot and ankle surgery were randomized to a popliteal sciatic nerve block completed with bupivacaine and epinephrine plus dexamethasone, or bupivacaine and epinephrine alone. The study assessed block duration and need for additional analgesia. Results demonstrated a significantly longer block duration in the dexamethasone group compared to the control group. Additionally, opioid analgesia consumption within the first 24 hours after surgery and cumulative opioid consumption over the first 48 hours after surgery were significantly lower in the dexamethasone group compared to the control group.