Comparative study between dexmedetomidine and fentanyl added to bupivacaine for ultrasound-guided brachial plexus block

Abstract

Background Ultrasonic guided supraclavicular brachial plexus block provides complete and reliable anesthesia for upper limb surgeries. Adjuvants to regional blocks can affect the block characteristics. Aim To evaluate supraclavicular block characteristics and adverse effects of the addition of dexmedetomidine or fentanyl to bupivacaine 0.5% in patients undergoing elective upper limb surgeries. Patients and methods This prospective double-blind trial was conducted on 90 patients scheduled for upper limb surgeries randomized into three equal groups. The patients in group C received 30 ml 0.5% bupivacaine with 1 ml normal saline, in group F received 30 ml bupivacaine 0.5% with fentanyl 50 µg (1 ml), whereas in group D received 30 ml bupivacaine 0.5% with dexmedetomidine 75 µg (1 ml). Sensory and motor block characteristics were assessed as well as the hemodynamics, adverse effects, and complications. Results Group D showed significantly rapid onset and longer duration of sensory and motor block, prolonged duration of anesthesia and analgesia, and higher sedation compared with C and F groups (P Conclusion Dexmedetomidine hastens the onset and prolongs the duration of sensory and motor blocks, as well as the duration of postoperative analgesia with minimal adverse effects compared with fentanyl when added to local anesthetic in supraclavicular brachial plexus block. We recommend further research studies for the determination of the optimum dose of dexmedetomidine used as an additive to local anesthetics.