Anesthésie et recherche clinique
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Dexmedetomidine as an Adjuvant to Bupivacaine in Supraclavicular Brachial Plexus Block

Rajesh Meena, Sandeep Loha, Arun Raj Pandey, Kavita Meena, Anil Kumar Paswan, Lalita Chaudhary, Shashi Prakash

Background: Many drugs have been used as adjuvants to local anesthetic agents to prolong the duration of peripheral nerve blocks and decrease the time of onset. In this study we assessed the effect of dexmedetomidine as an adjuvant to bupivacaine in supraclavicular brachial plexus block in terms of onset and duration of sensory and motor blockade, intraoperative sedation, postoperative analgesia, sedation and Complications /side effects if any. Methods: 60 patients of age 18-70 yrs were divided into two equal groups for upper limb surgeries under supraclavicular brachial plexus block. Group BD was given 39 millilitres (ml) of 0.5% Bupivacaine+1 microgram/kg dexmedetomidine; Group BS was given 39 ml of bupivacine+1 ml of saline. The following brachial plexus nerve block parameters were assessed hemodynamic parameters, onset and duration of sensory and motor blockade, Ramsay sedation score, verbal rating score, duration of analgesia, duration for rescue analgesia and number of analgesia given. Results: The onset of sensory blockade was 2.54 minutes less in Group (BD) when compared to Group (BS). The onset of Motor Blockade is 3.26 minutes less in Group (BD) when compared to Group (BS). The duration of sensory blockade is 195.65 minutes more in Group (BD) then Group (BS). The duration of Motor Blockade is 190.33 minutes more in Group (BD) when compared to Group (BS). The duration of Analgesia is 207.83 minutes more in Group (BD) when compared to Group (BS). Ramsay sedation score in Gp (BD)continued to show slightly higher sedation scores at all times including postoperative period in comparison to Gp (BS) (P<0.01). Conclusion: Dexmedetomidine is good adjuvant to local anesthestic agents, as its addition to bupivacaine was associated with prolonged sensory and motor blockade, mild sedation and prolonged analgesia. Satisfactory hemodynamic stability without observed immediate post-operative side effects are other significant qualities related to it.