A Clinical Comparision between 0.375% Ropivacaine and 0.375% Ropivacaine added with 0.5�g/kg dexmedetomidine in patients undergoing upper limb surgeries under supraclavicular brachial plexus block

Abstract

Introduction: Regional anesthesia is the preferred choice nowadays for upper limb surgeries because of their many advantages. Local anaesthetic added with alpha-2 agonists like dexmedetomidine, provide added advantages to the block. This study is aimed to assess onset and duration of sensory and motor block and post-operative analgesia in the first 24 hours surgery with the use of additives.Materials and Methods: 100 patients aged 18-60 years of ASA Grade I & II posted for upper limb surgeries under supraclavicular brachial plexus block were randomly allocated into two groups with 50 patients in each. Group R and R+D received 35cc of 0.375% injection Ropivacaine and 35cc of 0.375% Ropivacaine with 0.5 µg/kg of injection Dexmedetomidine respectively through nerve stimulator guided supraclavicular block. Onset and duration of sensory and motor block, time to first and total analgesic need were noted postoperatively for 12 hours.Results: Demographic variables were insignificantly comparable with p>0.05. Sensory and motor block onset time was significantly lower in the Group R+D than Group R (p=0.001). Duration of sensory and motor block was significantly longer in the Group R+D than Group R (p=0.001). The time to the first analgesic requirement was longer in Group R+D than Group R (p=0.001). The total analgesic requirement was significantly lower in Group R+D than Group R (p=0.001).Heart rate and systolic and diastolic blood pressure was significantly lower after drug administration in group R+D than group R.Conclusion: in supraclavicular block when Dexmedetomidine is added to Ropivacaine, sensory and motor blockade is achieved earlier with prolongation of postoperative analgesia and thus reduces requirement of pharmacological analgesics. Thus, Dexmedetomidine can be used as an effective adjuvant in supraclavicular blocks.