Supraclavicular Brachial Plexus Block: Comparision of Two Different Doses of Dexmedetomidine as an Adjunct to Bupivacaine: A Study

Abstract

Introduction: Supraclavicular brachial plexus block is commonly performed for upper limb surgeries. A variety of adjuvants are added to the local anaesthetic to fasten the onset and prolong the duration of sensorimotor block. Aim: To assess the efficacy of two different doses of Dexmeditomidine as an adjuvant in supraclavicular brachial plexus block. Materials and Methods: This was a prospective randomised study conducted on 99 ASA I and II patients, aged 18-60 years, posted for upper limb surgeries. Patients were randomised into three groups. Group S received 25 mL of 0.5% bupivacaine and 2 mL of NS, Group D20 received 25 mL of 0.5% bupivacaine and 20 µg of Dexmeditomidine in 2 mL NS, Group D40 received 25 mL of 0.5% bupivacaine and 40 µg of Dexmeditomidine in 2 mL NS. Statistical analysis was performed using ANOVA test and Bonferoni’s correction for intergroup comparison. Results: The onset of sensory block was faster in D40 group (8.94±2.99 minutes) compared to D20 (14.55±2.89 minutes) and S group (21.36±4.3 minutes). The onset of motor blockade was 24.55±4.5 minutes in S group, 16.97±16.97 minutes in D20 group and 10.15±2.92 minutes in D40 group. Duration of sensory block was longer in D40 (14.47±0.975 hours) compared to D20 (12.52±1.307 hours) and S group (7.27±1.26 hours). The total mean duration of motor blockade was 6.242±1.22 hours in S group, 11.17±1.254 hours in D20 group and 13.09±1.18 hours in D40 group. The haemodynamic parameters were comparable in all the three groups. Conclusion: Faster onset, longer duration of sensorimotor blockade and prolonged postoperative analgesia proved Dexmeditomidine was effective when used with bupivacaine as an adjuvant in supraclavicular blocks and the effect is also dose dependent.

Keywords

• haemodynamic stability
• sensorimotor blockade
• ultrasound guided nerve block