Perineural Dexmedetomidine as an Adjuvant to Ropivacaine in Supracalavicular brachial plexus nerve block
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 6, Issue 8
Abstract
Introduction: Regional anesthesia techniques provide important advantages including excellent pain control, reduced side effects, and shortened stay in the post-anesthesia care unit. However, these early advantages can be short lived and limited by the relatively brief duration of the action of currently available local anesthetics, potentially resulting in block resolution before the period of worst post-operative pain. Aim: The aim of the study is to compare the analgesic properties of perineural dexmedetomidine and intravenous dexmedetomidine to test the hypothesis whether the effect of dexmedetomidine is due to centrally mediated or its local action on nerve plexus. Methods: This randomized, triple arm, triple-blind, controlled study was conducted in patients undergoing upper limb surgeries done under supraclavicular brachial plexus nerve block. Group C: 30 mL 0.5% ropivacaine and 30 mL normal saline in IV, Group D: 30 ml ropivacaine 0.5% containing 1 mics/kg dexmedetomidine and 50 ml normal saline, and Group D IV: 30 ml ropivacaine 0.5% and 50 ml normal saline containing 1 mics/kg dexmedetomidine. Results: The onset of sensory block and motor block between groups is statistically significant. Perineural dexmedetomidine provides faster onset of sensory and motor block. Perineural dexmedetomidine prolongs the duration of both sensory and motor block. The quality of anesthesia was excellent in most patients in Group D and good in Group D IV and moderate in Group D IV. Conclusion: Perineural dexmedetomidine with ropivacaine provides prolonged post-operative analgesia, hastens the onset of sensory and motor block, and prolongs the duration.
Authors and Affiliations
K. Dinesh Kumar, J S Karthik Kamal, Chandrasekaran A
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