A Comparative Study Between 0.50% Bupivacaine And 0.50% Bupivacaine with Dexmedetomidine For Supraclavicular Brachial Plexus Block
Journal Title: International Journal of Medical Science And Advanced Clinical Research (IJMACR) - Year 2019, Vol 2, Issue 1
Abstract
Introduction: Post-operative analgesia plays an important role in the prevention of post-operative complications in the high risk group like IHD, COPD. Single shot nerve blocks have limited duration of sensory and motor blocks, whereas usage of continuous nerve blocks with placement of catheters is restricted due to financial constraints, which is overcome by adding adjuvants to local anaesthetics which prolongs the sensory and motor blocks. Aims And Objectives: The aim of the study was to compare the safety and efficacy of adding 50 μg Dexmedetomidine to 0.50% Bupivacaine in onset of block, duration of sensory block and motor block, requirement of opioid analgesics, backup analgesia in postoperative period and incidence of postoperative vomiting. Materials And Methods : 60 patients belonging to ASA 1and ASA 2 status of age group between 18-60 years scheduled for elective upper limb surgeries were selected for this prospective randomized double blinded comparative study. They were randomly divided by sealed envelope technique into 2 groups. Group C (Control group), where patients received 30 mL of 0.50% Bupivacaine with 2 mL of normal saline and Group D (Dexmedetomidine group), where patients received 30 mL of 0.50% Bupivacaine with 50 μg of dexmedetomidine for supraclavicular block in patients scheduled for upper limb surgeries. Inj. Midazolam 1 mg given IV before block to reduce the anxiety, Inj pentazocine given IV before starting of surgery as an Intraoperative analgesic at the dose of 0.60mg/kg. Results: There was no significant difference in onset of block between two groups. Duration of motor block and sensory block is significantly prolonged in group D than group C. Postoperative backup and opioid analgesic requirement is significantly lower in group D compared to group C. Incidence of postoperative vomiting is significantly lower in group D compared to group C. Conclusions: Addition of Dexmedetomidine as an adjuvant to Bupivacaine for supraclavicular brachial plexus block significantly prolongs the duration of sensory and motor block in patients undergoing upper limb surgeries. Addition of Dexmedetomidine to local anaesthetics is remarkable, safe and cost effective method of providing postoperative analgesia in the absence of brachial plexus catheters. Requirements of opioid analgesic and backup analgesic, postoperative vomiting were significantly lower in Dexmedetomidine group compared to group C.
Authors and Affiliations
Dr. Shahzad Akhter
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