Abstract
Background: Axillary brachial plexus block is used for surgeries on forearm, hand and wrist. By adding α2 receptor agonist to local anaesthetic drugs we can hastens the onset, duration, quality of sensory and motor block with prolong postoperative analgesia.
Aim: In this study, we studied the effects of adding dexmedetomidine to levobupivacaine for an axillary brachial plexus block.
Setting and Design: Patients of ASA grade I and II, age 18 to 60 years of either sex were enrolled in this prospective study. They were randomly allocated into two groups of thirty each by computerized method.
Methods and Material: Group L received 40 ml of 0.5% levobupivacaine + 1 ml Saline, and Group LD received 40 ml of 0.5% levobupivacaine + 1µg /kg dexmedetomidine.
Statistical analysis: The data was analysed using two independent sample t-tests, chi-square tests and Mann-Whitney U test as applicable.
Result: The onset of sensory and motor block was earlier in Group LD 8.09 ±0.48 min and 15.54±0.94 min as compared to Group L 10.94 ±0.85 min and16.78 ± 1.13 min (p<0.001) respectively. The mean duration of sensory and motor blockade was 930 min and 810 min in Group LD and 680 min and 546 min in Group L (P<0.001) respectively. The time to rescue analgesia was 1279.50 min in Group LD and752 min in Group L (P <0.001). More patients in group LD had excellent satisfaction than group L (P=0.008).
Conclusions: Adding dexmedetomidine to levobupivacaine for an axillary brachial plexus block shortens both the sensory and motor block onset time, extends the duration of block and analgesia.
Keywords: axillary brachial plexus block, dexmedetomidine, levobupivacaine,
References
- Esmaoglu A,Yegenoglu F, Akin A, Turk CY. Dexmedetomidine added to levobupivacaine prolongs axillary brachial plexus block. Anesth Analg.2010;111 (6):1548-51.
- Kenan K, Iclal O, Cevdet D, Sinan G, Hayati O, Ulku K, et al. Effect of adding dexmedetomidine to levobupivacaine in axillary brachial plexus block.Current Therapeutic Research 2012;73 (3):103-111.
- Kapral S, Gollmann G, Waltl Bet al. Tramadol added to mepivacaine prolongs the duration of an axillary brachial plexus blockade. Anesth Analg1999;88:853.
- Singelyn F, Gouverneur J, Robert A. A minimum dose of clonidine added to mepivacaine prolongs the duration of anaesthesia and analgesia after axillary brachial plexus block. Anesth Analg 1996;83: 1046–1050.
- Singelyn F, Dangoisse M, Bartholomee S, Gouverneur J. Adding clonidine to mepivacaine prolongs the duration of anaesthesia and analgesia after brachial plexus block. Reg Anesth 1992;17:148–150.
- Gaumann D, Forster A, Griessen M et al. Comparison between clonidine and epinephrine admixture to lidocaine in brachial plexus block . Anesth Analg1992;75:69–74.
- Memis D, Turan A, Karamanlioglu B, Pamukcu Z, Kurt I. Adding dexmedetomidine to lidocaine for intravenous regional anaesthesia. Aneth Analg2004; 98(3):835-40.
- Kanazi G, Aouad M , Jabbour-Khoury S, Aj Jazzar M, Alameddine M, Al-Yaman R, Bulbul M, et.al. Effect of Small Dose Dexmedetomidine or Clonidine on the Characteristics of Bupivacaine-Spinal Block. Acta Anaesthesiol Scand 2005; 50:222-7.
- Abosedira M . Adding clonidine or dexmedetomidine to lidocaine during Bier's block: a comparative study .J M Sci 2008;8:660–664.
- Culebras X,Van Gessel E, Hoffmeyer P, Gamulin Z. Clonidine combined with a long acting local anaesthetic does not prolong postoperative analgesia after brachial plexus block but does induce hemodynamic changes. Anesth Analg. 2001;92(1):199-204.
- Sia S, Lepri A. Clonidine administered as an axillary block does not affect postoperative pain when given as the sole analgesic. Anesth Analg 1999;88:1109–1112.
- Erlacher W, Schuschnig C, OrlicekF et al. The effects of clonidine on ropivacaine 0.75% in axillary perivascular brachial plexus block. Acta Anaesthesiol Scand 2000;44: 53–57.
- Esmaoglu, Mizrak A, Akin A et al. Addition of dexmedetomidine to lidocaine for intravenous regional anaesthesia. Eur J Anaesthesiol 2005;22: 447–451.
- Amany S A,Khaled M M. “Ultrasound-guided single injection infraclavicular brachial plexus block using
- bupivacaine alone or combined with dexmedetomidine for pain control in upper limb surgery: A prospective randomized controlled trial” . 2012; 6 ( 2 ) : 109-114.
Corresponding Author
Bhalerao Pradnya
BJ Medical College