EFFECT OF DEXMEDETOMIDINE AS AN ADJUVANT WITH LEVOBUPIVACAINE IN AXILLARY BRACHIAL PLEXUS BLOCK

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EFFECT OF DEXMEDETOMIDINE AS AN ADJUVANT WITH LEVOBUPIVACAINE IN AXILLARY BRACHIAL PLEXUS BLOCK

Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 16

Abstract

BACKGROUND The surgeries in the upper limb can be done either by general or regional anaesthesia or by the combination of both.1 Regional blockade has wide application in providing surgical anaesthesia and analgesia as well as in treating chronic pain syndromes. Regional anaesthesia has several advantages in the postoperative period compared with general anaesthesia including decreased sedation, decreased nausea and vomiting, early discharge from the recovery room and a smooth transition to pain control as the block effects gradually dissipate. The first demonstration of axillary approach to brachial plexus was done by William Halsted in 1884. He injected cocaine under direct vision. The first percutaneous axillary block was done by G. Hirschel in 1911. The axillary approach to brachial plexus blockade provides satisfactory anaesthesia for elbow, forearm and hand surgery.2 Aims and Objectives- To evaluate the effect of adding dexmedetomidine as an adjuvant with levobupivacaine in axillary brachial plexus block and to evaluate the adverse effect and onset time for sensory and motor blockade during analgesia. MATERIALS AND METHODS This prospective, randomised, controlled trial study was conducted in Govt. Mohan Kumaramangalam Medical College, Salem from 2016 - 2017. Ethical committee clearance was duly obtained from the Hospital. For the sake of convenience, it was decided to include 64 subjects in the study with 32 subjects randomised to each of the two study groups. Randomisation of the population is allocated into these defined groups according to computer generated random numbers. RESULTS This study shows the addition of Dexmedetomidine to Levobupivacaine in axillary brachial plexus block results in a shorter onset time for sensory and motor blockade. It also prolongs the duration of sensory and motor blockade and also the duration of analgesia. However, dexmedetomidine use may also lead to bradycardia. CONCLUSION The addition of 1 mL Dexmedetomidine to 29 mL of 0.5% Levobupivacaine in axillary brachial plexus block results in a shorter onset time for sensory and motor blockade. It also prolongs the duration of sensory motor blockade and also the duration of analgesia in patients between 20 years to 50 years of age undergoing forearm and hand surgeries of both sexes.

Authors and Affiliations

Rajkumar P, Murugesan K

Keywords

Axillary Block Subclavian Artery Nerve Stimulator.

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EP ID EP414627
DOI 10.14260/jemds/2018/444
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