Title: Comparison of Dexmedetomidine and Fentanyl as an Adjuvant to 0.25% Bupivacaine in Supraclavicular Brachial Plexus Block
Authors: Bharat Kumar, Vaijayanti Gadre, Padara Basavaraj
DOI: https://dx.doi.org/10.18535/jmscr/v5i11.221
Abstract
Introduction: relief of intra and post operative pain has gained importance in recent years. Nerve blocks from the cornerstone in this arena. Brachial plexus block is a commonly used technique for majority of upper limb surgeries.
Aim: To evaluate the effect of dexmedetomidine and fentanyl as an adjuvant to low dose bupivacaine 0.25% in terms of onset, duration, and quality of sensory and motor block when used for supraclavicular brachial plexux block.
Materials and Methods: after the approval of ethical committee, 80 ASA grade I and II patients of either sex, between 18-60 years of age undergoing orthopaedic and plastic surgeries under supraclavicular block were studied after randomly assigning them into two groups of 40 each.
Group D: Bupivacaine 0.25% (34 ml) +dexmedetomidine 1 microgm/kg
Group F : Bupivacaine 0.25% (34 ml) +fentanyl 1 microgm/kg
After baseline investigations and preoperative routine assessment, the consenting patients were premedicated with inj midazolam 0.03 mg/kg and inj glycopyrrolate 5 microgm per kg Iv 10 minutes prior to surgery after putting ECG,NIBP ,SPO2 monitors and securing 18 G IV cannula in the non operative upper limb. Block was given using paresthesia technique. Onset ,duration and quality of both sensory and motor block in either group were studied .use of rescue analgesia in both the groups in post operative period was compared up to 24 hours.
Results: onset of both sensory and motor block was faster, 2.95 +/- 0.0693 minutes in group D versus 4.275+/-0.933 minutes in group F ; and 5.45+/-0.86 minutes in group D versus 6.025+/-0.861 minutes in group F respectively; total duration of block was prolonged, 608+/- 38.84 minutes in group D and 383+/-27.66 minutes in group F
Conclusion: dexmedetomidine is superior to fentanyl as an adjuvant to low dose bupivacaine for supraclavicular brachial plexus block.
Keywords: dexmedetomidine, fentanyl, pain relief, nerve blocks, supraclavicular block.
