Aim and background: Brachial plexus block is one of the commonest regional anesthesia technique used for Upper limb surgeries in orthopedic and plastic reconstructive cases. With the use of ultrasound the accuracy and success rate of the nerve block is improved. Adding Adjuvant like opioids and α-2 adrenergic agonist to local anesthetic agent have increased the duration of analgesia. Aim of our study is to compare the effect of dexmedetomidine and buprenorphine added to local anaesthetics in ultrasound guided brachial plexus block in terms of onset and duration time of  the sensory and motor block, their side effects and complication.

Methods: 60 ASA I and II patients posted for upper limb surgeries were randomly divided into Group I : Dexmedetomidine 1 mcg/kg added to bupivacaine 2 mg /kg and  Group II : Buprenorphine  0.3 mg added to to bupivacaine 2 mg/kg. Vitals signs, motor blockade and sensory blockade onset and duration were recorded peri-operatively.

Results: Onset of sensory and motor block are similar in both group. The duration of sensory and motor blockade are longer in group II than in group I . Motor blockade mean duration in group I and II are 660.34 ± 40.6 and 740.18 ± 28.4 respectively. Postoperative pain and PONV are reduced in both groups. No procedure related complication or drug related side effects were recorded in our study.

Conclusion: Use of ultrasound for brachial plexus block improves the quality of the blockade with minimal drug volume and therefore reducing their systemic toxicity. Both dexmedetomidine and buprenorphine added to bupivacaine increases duration of sensory and motor blockade about 2 -3 times that of brachial plexus block with local anesthetic alone and with reduced postoperative pain and PONV.

Keywords: 1.Brachial plexus block 2. Ultrasound 3.dexmedetomidine 4.Buprenorphine.5.Motor blockade 6. visual analogue score (VAS).