Comparative Study of Ropivacaine with Dexmedetomidine versus Ropivacaine Alone In Supraclavicular Brachial Plexus Block for Upper Limb Surgery
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2018, Vol 3, Issue 2
Abstract
Background and Aims:Supraclavicular plexus block, as a regional anaesthesia has taken over as principal technique for upper limb surgeries. Different additives have been used to prolong brachial plexus block.Dexmedetomidine has been reported as an effective adjuvant for regional anesthetic agents. The present study was conducted to compare and evaluate the effectiveness of ropivacaine with dexmedetomidine versus ropivacaine alone in supraclavicular brachial plexus block for upper limb surgeries . The primary endpoints were the onset and duration of sensory and motor block and duration of analgesia, hemodynamics and side-effects.Materials and Methods:A total of 80 patients (20-55years) posted for elective forearm and hand surgery under supraclavicular brachial plexus block were divided into two equal groups (Group R and RD) in a randomized, double-blinded fashion. Group R: 0.50% Ropivacaine (30 cc) +0.5 ml normal saline and Group RD: 0.50% Ropivacaine (30 cc) + Dexmedetomidine 50 μg. Both groups were compared for complete onset time and total duration of sensory blockade, complete onset time and total duration of motor blockade, total duration of analgesia, hemodynamics and side-e ffects.Results:Though with similar demographic profile in both groups, sensory and motor block in group RD (P < 0.05) was earlier than group R. Sensory and motor block duration and time to first analgesic use were significantly longer in group RD (P < 0.05) than group R. Intra-operative hemodynamics were comparable in both groupswithout any appreciable side-effects. The mean onset time for a complete sensory block in Group R was 19.89± 7.86 min, in Group RD was 16.72± 4.76 min (P = 0.001) and the mean onset time for complete motor block in Group R was 22.46± 3.92 min, and in Group RD was 20.68± 2.85min (P = 0.00001) which were statistically significant. The mean duration of sensory block in Group R was 639.89± 78.86min and in Group RD was 806.72± 48.76min and the mean duration of motor block in Group R was 515.67± 173.92 min, and in Group RD was 636.95± 132.85 min which were statistically significant (P = 0.00001). The mean duration of analgesia in Group R was 286.34± 66.35 min and in Group RD was 403.83 ± 81.43min which was statistically significant (P = 0.00001). Conclusion: It can be concluded that adding dexmedetomidine to supraclavicular brachial plexus block hasten onset of sensory and motor block, increases the sensory and motor block duration and time to first analgesic use, and decreases total analgesic use with no side-effects.
Authors and Affiliations
Dr. Kumar Shailesh
Keywords
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