Effect of Adding Dexmedetomidine as an Adjuvant to 0.5% Ropivacaine in Supraclavicular Brachial Plexus Block- a Randomized Controlled Study

Abstract

Introduction - Dexmedetomidine has been demonstrated to be safe and effective in various neuraxial and regional anesthetic procedures in humans, with fewer adverse effects in several studies.Methodology - This study aimed to study and compare the efficacy of Dexmedetomidine 1μg/kg plus 0.5% Ropivacaine versus 0.5% Ropivacaine alone in brachial plexus block by supraclavicular approach. After obtaining institutional ethics committee approval this prospective, randomized, comparative study was conducted on 60 patients, 18-60 years, either sex scheduled for elective upper limb surgery under supraclavicular brachial plexus block. The primary objective was to study the effects of 0.5% Ropivacaine with Dexmedetomidine 1μg/kg in brachial plexus block in the form of onset and duration of sensory and motor blockade. Secondary objectives included grading the quality of motor block, Sedation Score, Duration of analgesia, Hemodynamic changes, and Side effects, if any.Observations - Group D showed a faster onset and a longer duration of sensory and motor blockage. Rescue analgesia was given with Injection Diclofenac Sodium 75 mg intravenous when patient Numeric Rating Score> 4. The mean sedation score was comparable at baseline, 5th and 10th minutes (P>0.05), significantly higher in Group D from 15th to 480th minutes (P<0.05), and subsequently comparable from 600th to 1440th minutes (P>0.05).Conclusion - When given as an adjuvant to Ropivacaine 0.5% in supraclavicular brachial plexus block, Dexmedetomidine significantly reduces the onset time and increases the duration of sensory and motor block. It also provides excellent sedation during surgery, improves the quality of block, extends the duration of analgesia, and does not cause significant respiratory depression