A COMPARATIVE STUDY OF DEXMEDETOMIDINE AS AN ADJUVANT TO BUPIVACAINE WITH ONLY BUPIVACAINE IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK

Dr. Seema Sharma* and Dr. Pancham Mehta

ABSTRACT

Upper limb surgeries are mostly performed under peripheral blocks such as the brachial plexus block. Peripheral nerve blocks not only provide intraoperative anaesthesia but also extend analgesia in the post-operative period without any systemic side-effect. Alpha-2 adrenergic receptor agonists like clonidine and dexmedetomidine have been the focus of interest during anaesthesia for their sedative, analgesic, perioperative sympatholytic and cardiovascular stabilizing effects with reduced anaesthetic requirements Objective: The aims of present study were to compare the analgesic efficacy of dexmedetomidine as an adjuvant to bupivacaine with only bupivacaine in supraclavicular brachial plexus block in reference to:  Onset and duration of sensory and motor block  Duration of analgesia  Hemodynamic changes  Sedation score  Any complication. Method: The present study was carried out in 60 adult patients of ASA I/II posted for various elective upper limb surgeries after taking written inform consent. The patients were randomly allocated in two groups; each group was having 30 patients. Group B – Inj. Bupivacaine 0.25% 40 ml + Inj. Normal saline O.9% 0.5ml Group D – Inj. Bupivacaine 0.25% 40 ml + Inj. Dexmedetomedine 0.5ml (50mcg) Result: Demographic data were comparable in both the groups. We found that onset of sensory block was 7.25 ± 0.50 min in Group D and 11.05 0.69 min in Group B (p<0.0001). The onset of motor block was 8.59 ± 0.63 min in group D and 14.42 ± 0.82 min in group B (p<0.0001). It shows that onset time of sensory and motor block had shortened in Group D compared to Group B. Conclusion: dexmedetomidine 50mcg when added to bupivacaine for supraclavicular brachial plexus block shortens the onset time, prolongs the duration of the block and postoperative analgesia. The added advantage of conscious sedation, hemodynamic stability, and lack of significant side effects like respiratory depression make dexmedetomidine an attractive choice as an adjuvant for peripheral nerve block.

Keywords: Bupivacaine, Dexmedetomidine, Analgesic , Supraclavicular block.