Dexmedetomidine as an adjuvant to ropivacaine in supra-clavicular brachial plexus block
Journal Title: Medpulse International Journal of Anesthesiology - Year 2018, Vol 7, Issue 1
Abstract
Background and Aim: The advantages of a supraclavicular technique over other brachial plexus block approaches are its rapid onset and complete and predictable anesthesia for entire upper extremity and particularly, hand surgery. In this study, we observed the efficacy and safety of dexmedetomidine as an adjuvant to ropivacaine in supraclavicular brachial plexus block. Method: Thirty five American society of anaesthesiologist class I and II adult patients who were scheduled to undergo upper limb hand surgery were randomly allocated to following groups to receive unilateral supraclavicular block: Ropivacaine 0.5% (30 ml) + dexmedetomidine 1 μg/kg All the patients were assessed for Onset of sensory block, Onset of motor block, Duration of sensory block, Duration of motor block, Duration of analgesia, Haemodynamic stability, Ramsay sedation score. Any complications such as pneumothorax, hematoma, arrythmias, tinnitus, dizziness, circumoral numbness and seizures was noted and documented. Result: The mean duration of sensory block was 780.3±39.0 min with Ropivacaine and Dexmedetomidine. The mean duration of motor block was 711.1±39.5 min with Ropivacaine and Dexmedetomidine. The mean duration of analgesia with Ropivacaine and Dexmedetomidine was 864.0±44.7 min. Ropivacaine and Dexmedetomidine were similar with regard to pulse rate, mean arterial blood pressure and oxygen saturation. There was no statistically significant difference (P > 0.05). Conclusion: We conclude that dexmedetomidine, 1 μg/kg when added as an adjuvant to ropivacaine in supraclavicular brachial plexus block has significantly prolonged the duration of analgesia along with significant increase in the duration of sensory and motor blockade. Dexmedetomidine also provided better arousable sedative effects without any side effects. So dexmedetomidine is a better adjuvant in supraclavicular brachial plexus block for upper limb surgeries.
Authors and Affiliations
P V Bhale, Tejas Warkari, Pannag Bhushan Dasmohapatra
Keywords
Related Articles
- EP ID EP414586
- DOI -
- Views 149
- Downloads 0
Clinical profile and outcome of children admitted for dengue with warning signs and severe dengue
Objective: To study clinical profile and outcome of children with dengue with warning signs and severe dengue. Design: Prospective observational study over period of one year. Subjects and methods: Ninety five children d...
Efficacy of bupivacaine infiltration for postoperative pain relief in paediatric patients
Background: The effective control of pain remains one of the most important issues in the postoperative care today. Local infiltration of bupivacaine requires less skill and is better technique for postoperative pain rel...
Comparison of hemodynamic stability of combined spinal anesthesia with low dose spinal anesthesia and epidural volume extension by saline as compared to epidural anaesthesia for patients undergoing elective lower limb surgery
Administration of saline in epidural space following intrathecal drug administration constitutes Epidural Volume Extension. In our study we involved 40 patients who were planned to undergo elective lower limb surgery, wh...
Comparison of post-operative analgesic efficacy of bupivacaine and ropivacaine using ultrasound guided oblique subcostal transverse abdominis plane block in open cholecystectomy under general anaesthesia
Background: Cholecystectomy involves upper abdominal incision with considerable postoperative pain. Adequate postoperative analgesia has to be provided to prevent major pulmonary complications in the postoperative period...
A double blind, randomized, controlled trial to study the effect of dexmedetomidine on hemodynamic and recovery responses during tracheal extubation
Background: Extubation is known to produce significant hemodynamic disturbances. Literature claims that dexmedetomidine, provides excellent cardiovascular stability, no respiratory depression and may be a useful adjunct...