Comparison of anaesthetic efficacy of nalbuphine and dexmedetomidine as an adjuvant to ropivacaine and lignocaine in supraclavicular block for upper limb surgeries

Abstract

INTRODUCTION: Brachial plexus block provides an useful alternative to general anaesthesia for upper limb surgeries. Ropivacaine newly emerging local anaesthetics is used. And dexmedetomidine an alpha 2 agonist and nalbuphine opioid agonist –antagonist are used as adjuvants to improve the quality and density of block. AIM OF THE STUDY: To study the duration of postoperative analgesia. MATERIALS AND METHODS: A randomized prospective controlled double blind study was undertaken in patients who were posted for upper limb surgeries under brachial plexus block. 60 patients with ASA class I and II were randomly grouped into two groups. Group N received 20 ml of ropivacaine 0.5%, 10 ml lignocaine 2% mixed with 10mg of nalbuphine and Group D received 20 ml of ropivacaine 0.5%, 10 ml of lignocaine 2% with 50 microgram of dexmedetomidine. RESULTS: Group D had quicker onset of block and prolonged duration of postoperative analgesia when compared to group N. DISCUSSION: Addition of dexmedetomidine to ropivacaine 0.5% speeds the onset of sensory and motor blockade, also prolongs the duration of postoperative analgesia, thus reducing the requirements of rescue analgesics. Nalbuphine though not in par with dexmedetomidine but still prolonged the duration of analgesia. CONCLUSION: Combination of ropivacaine 0.5% and dexmedetomidine has significantly faster onset and prolonged duration of postoperative analgesia.