L.R.N.N. Paidikondala1, Kommula Gopala Krishna2, P. Subhamani3, P. Sudhir Sirkar4
BACKGROUND
To improve the quality of block (sensory and motor characteristics), postoperative
pain management and reduce large doses of local anaesthetics, various adjuvants
are used with local anaesthetic agents. We have evaluated dexmedetomidine as
an adjuvant to 0.5 % ropivacaine in supraclavicular brachial plexus block in terms
of onset and duration of sensory and motor block & duration of postoperative
analgesia.
METHODS
This is a prospective randomised comparative study. 60 patients who were
admitted for elective surgeries of the lower arm, at the level of elbow, forearm &
hand were enrolled. They were divided in to two groups of 30 patients each as
follows - group RD: supraclavicular brachial plexus block given with 30 mL of 0.5
% ropivacaine + 1 mL (100 μg) of dexmedetomidine. Group RC: supraclavicular
brachial plexus block given with 30 mL of 0.5 % ropivacaine + 1 mL of normal
saline. Various parameters like onset times and durations of sensory and motor
block, duration of analgesia, total analgesic needed, and side-effects were
recorded for each patient.
RESULTS
The time of onset of sensory and motor block was significantly early in
dexmedetomidine group than in control group. The duration of sensory and motor
block was significantly prolonged in group RD as compared to group RC. The
duration of sensory block was 724.18 + 73.26 min in group RD (GD) and 582.16
+ 93.12 min. in group RC (GC). The duration of analgesia was significantly
prolonged in group RD.
CONCLUSIONS
Addition of dexmedetomidine as an adjuvant to ropivacaine is associated with early
onset of sensory and motor block. The duration of sensory and motor block was
prolonged. The duration of analgesia was prolonged and patients required less
rescue analgesia. The use of dexmedetomidine was associated with reversible
bradycardia and sedation score was less.
