Effect of axillary perineural dexmedetomidine on hemodynamic changes and postoperative pain in patients undergoing upper limb surgery under general anesthesia: A randomized double-blind study

Abstract

Background and Objectives: Perineural dexmedetomidine as an adjuvant of local anesthetics has been used in regional anesthesia to prolong the duration of analgesia. This study aimed to assess the effects of perineural injection of dexmedetomidine alone on the duration of postoperative analgesia, narcotic consumption, and hemodynamic changes in the patients undergoing upper limb surgery under general anesthesia. Methods: Sixty patients undergoing upper limb surgery were randomly allocated into two equal groups. The intervention group received 100 μg dexmedetomidine/20 ml normal saline (NS) as perineural axillary brachial plexus injection, whereas the control group received 20 ml NS injection. Patients were compared for hemodynamic changes, postoperative pain through Visual Analog Scale, consumed narcotics and side effects. Results: The postoperative analgesia in the dexmedetomidine group was significantly longer than the control one. The amount of opioid administered in the control group was significantly more than that amount used in the intervention group. Mean arterial pressure (MAP) and heart rate (HR), in parallel, in the intervention group at 15, 30, 45, and 60 min after induction of anesthesia were significantly decreased in the intervention group than the control group. No dramatic drop in MAP and HR was observed. No significant complication also was reported. Conclusions: Perineural axillary brachial plexus injection of 100 μg dexmedetomidine/20 ml NS prolonged postoperative analgesia and reduced narcotic consumption in patients undergoing upper limb surgery under general anesthesia without noticeable side effects.

Keywords

• analgesia
• brachial plexus
• dexmedetomidine
• upper extremity
• visual analog scale