Background:  Supraclavicular brachial plexus block is a frequently performed procedure to provide anesthesia and postoperative analgesia for upper limb surgeries.  Bupivacaine is the most commonly used anesthetic, but ropivacaine has been successfully used as it is less cardiotoxic, less arrhythmogenic. Adjuvants to local anesthetics enhance the quality and duration of analgesia.

Aim: To compare the effects of fentanyl and dexmedetomidine as adjuvants to ropivacaine in brachial plexus block.

Materials & Method: After informed consent, sixty ASA I and II patients scheduled for upper limb surgeries under supraclavicular block randomly allocated into two groups of 30 each. GROUP D received 30ml of 0.5% ropivacaine with 20 µg dexmedetomidine and GROUP F received 30ml of 0.5% ropivacaine with 50µg fentanyl. Onset and duration of sensory and motor block, duration of analgesia were compared.

Results:  Demographic variables were comparable between the two groups. The onset of sensory block in group F is 9.1 ± 1.84 min, and group D is7.56 ± 1.81 min(<0.0019). The onset of motor block in group F is 15.6 ± 2.65 min and group D is 11.7 ± 2.28 min(<0.0001). Duration of sensory in group F and group D is 509.4 ± 45.43 min and 683.83 ± 96.96 min respectively(<0.0001). Duration of motor block in group F and group D is 457.6 ± 43.58 min and 618.7 ± 100.7 min respectively(<0.0001). Duration of analgesia in group F is596.9 ± 59.5 min and group D is770.66 ± 110.19 min(<0.0001). Significant difference observed in duration of sensory, motor block, and analgesia between the two groups.

Conclusion: Dexmedetomidine is better adjuvant to ropivacaine than fentanyl as it enhances the duration of block and analgesia without adverse hemodynamic consequences.

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Dr Kadiri Srujana

Postgraduate, Department of Anaesthesiology, Andhra Medical College, Visakhapatnam, AP