Title: Dexmedetomidine as an Adjuvant with Ropivacaine in Supraclavicular Brachial Plexus Block in Upper Limb Surgeries: A Case Control Study

Authors: Dr Sonam Sushilkumar Gupta, Dr Jayant Prakashrao Shinde

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i11.116

Abstract

Background and Aims: The aim of this study was to find out the effect of Dexmedetomidine used as an adjuvant with Ropivacaine in Supraclavicular brachial plexus block in upper limb surgeries.

Materials and Methods: 80 patients undergoing elective upper limb surgeries under Supraclavicular brachial plexus block and belonging to American society of Anesthesiologists Grade I or II were divided into 2 groups of 40 patients each. Group A (n=40) received 30 ml 0.5% Ropivacaine and 1 ml normal saline and Group D (n=40) received 30 ml 0.5% Ropivacaine and 1 μg/kg of Dexmedetomidine. The primary outcome was evaluated in term of duration of analgesia. Other outcomes which were evaluated included time of onset and duration of sensory and motor blockade, degree of analgesia and sedation, vital parameters during and in immediate postoperative period.

Results: Demographic profile and mean duration of surgery was similar in both the groups. Onset of sensory and motor blockade was found to be earlier in Group D than in Group A. The duration of sensory and motor block was statistically significantly prolonged in group D than in group A. Duration of analgesia and degree of sedation was also higher in group D than in group A. The incidence of bradycardia was more in group D than in Group A. Other vital parameters like mean arterial pressure and SPO2 were comparable in both the groups. 

Conclusion:  Addition of dexmedetomidine as an adjuvant to ropivacaine in supraclavicular brachial Plexus block in upper limb surgeries is associated with prolonged postoperative analgesia, better sedation and shortened time for onset of sensory and motor block. It is associated with statistically significant prolonged duration of brachial plexus block in comparison with use of ropivacaine alone. Use of dexmedetomidine is found to be associated with increased incidence of bradycardia.

Keywords: Dexmedetomidine, Ropivacaine, Supraclavicular brachial plexus block, Bradycardia, Analgesia and Sedation.

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Corresponding Author

Dr Jayant Prakashrao Shinde

Senior Resident, Department of Anesthesiology,

Dr Shankarrao Chavan Government Medical College, Nanded (MS)- India