A comparative study of supraclavicular block, interscalene block, and combination of supraclavicular with interscalene block using 0.5% ropivacaine and dexmedetomidine as adjuvant by nerve stimulation technique in upper limb surgery

Abstract

Background: Anesthesia for upper limb surgeries may include general anesthesia, regional anesthesia, or combination of both. Compared with general anesthesia, brachial plexus regional anesthesia technique is preferred for upper limb surgeries. Aims and Objectives: A comparative study of supraclavicular block, interscalene block, and combination of supraclavicular and low interscalene blocks using 0.5% ropivacaine and dexmedetomidine as adjuvant by nerve stimulation technique in upper limb surgery in terms of the onset of sensory and motor block and duration of sensory and motor block. Materials and Methods: The patients in supraclavicular block group (n = 20) were given supraclavicular block, in interscalene block (IRD) group (n = 20) were given low interscalene block, and in combination of supraclavicular and interscalene block (ISRD) group (n = 20) were given combination of supraclavicular block and low interscalene block using nerve stimulator by injecting 30 ml 0.5% ropivacaine and 50 μg dexmedetomidine in each group. Results: The results showed that there was no statistically significant difference seen in demographic and hemodynamic parameters. Combined supraclavicular block and low interscalene block had statistically better outcomes than supraclavicular block and low interscalene block individually. Conclusion: The onset of sensory and motor block in combined supraclavicular and interscalene blocks as significantly faster with prolonged duration of sensory and motor block followed by low interscalene block and supraclavicular block, respectively. There were no significant complications encountered during the procedure.