COMPARATIVE STUDY OF THE EFFECT OF ADDITION OF DEXMEDETOMIDINE AS AN ADJUVANT TO LOCAL ANAESTHETICS IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2019, Vol 6, Issue 12
Abstract
BACKGROUND Brachial plexus block is a popular and widely employed regional nerve block of the upper extremity. A variety of adjuvants have been used to enhance the effect of local anaesthetics in peripheral nerve block. In this study, we evaluated the effect of Dexmedetomidine as an adjuvant to 0.5% Bupivacaine plus 2% Lignocaine hydrochloride with adrenaline (1 in 200000) in Brachial plexus block in terms of onset and duration of sensory and motor block, duration of analgesia and hemodynamic effects. MATERIALS AND METHODS Sixty patients of age 18-60 yrs. belonging to ASA grade I and ASA II who came for upper limb surgery below the shoulder joint under brachial plexus block through supraclavicular route were divided into two equal groups. Group BS was given 20 millilitres (ml) of 0.5% Bupivacaine + 20 mL of 2% lignocaine with adrenaline (1 in 200000) + one ml of Normal saline and Group BD was given 20 mL of 0.5% bupivacaine + 20 mL of 2% lignocaine with adrenaline (1 in 200000) + 50 mcg of Dexmedetomidine (1 mL). The following brachial plexus nerve block parameters were assessed: onset and duration of sensory and motor blockade, duration of analgesia, Ramsay sedation score, hemodynamic parameters, and any side effects. RESULTS There were no significant differences in the patient and surgery characteristics between the two groups. The onset of sensory blockade in group BD was 7.07±4.502 minutes and in group BS was 7.33±3.294 minutes (p value = 0.794) which is comparable. The onset of motor blockade was 14.87±5.38 minutes in group BD and 16.30±3.109 minutes (p value =0.211) in group BS which is statistically insignificant. The duration of sensory blockade (BD = 534.83±149.09 minutes vs BS = 302.17 ±65.465 minutes) and motor blockade (BD = 425.50±140.19 minutes vs BS=256.83±58.758 minutes) was longer in group BD compared to group BS with a p value <0.05 which is statistically significant. The duration of analgesia was also longer in group BD (582.83±198.44 minutes) when compared to group BS (326.33±60.78 minutes) with a p value = 0.002 which is statistically significant. Patients in group BD showed slightly higher Ramsay sedation scores when compared to group BS. CONCLUSION Dexmedetomidine is a good adjuvant to local anaesthetic agents, as its addition to bupivacaine and lignocaine was associated with prolonged sensory and motor blockade with relative hemodynamic stability and greater postoperative analgesia and no significant side effects.
Authors and Affiliations
Vangali Sreelakshmi, Bukke Tapas Naveen Kumar, Somula Vijayadurga
Keywords
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- EP ID EP615676
- DOI 10.18410/jebmh/2019/214
- Views 84
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