Publication: Effect of Dexmedetomidine with Ropivacaine in Supraclavicular Brachial Plexus Block
Date
2019
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
Brachial plexus block is popular choice for upper limb surgeries and offers good and
relatively safe anesthesia. Among various approaches supraclavicular approach is
the most consistent method for anaesthesia and postoperative pain management in
surgery below the elbow joint. Many drugs are used as adjuvants in brachial plexus
block for faster onset, denser block and for prolongation of postoperative analgesia.
Dexmedetomidine also has been shown to prolong the sensory and motor duration
when added as an adjuvant to local anaesthetic in nerve blocks.
Objective
To assess the effect of adding dexmedetomidine to ropivacaine in brachial block.
Method
Sixty patients, planned for upper limb surgeries under ultrasound guided brachial
block were randomly allocated into two groups. Group RS (n=30) received 30 ml of
0.5% Ropivacaine + 1 ml Normal Saline and Group RD (n=30) received 30 ml of 0.5%
Ropivacaine + 0.75 mcg/kg Dexmedetomidine diluted to 1 ml solution. The onset
time to sensory and motor blockade were recorded. The duration of sensory and
motor block and duration of analgesia were recorded.
Result
The mean time to onset of sensory block (12.60±2.67 min Vs 22.17±2.81 min) and
motor block (14.20±3.22 min Vs 22.53±3.97) in Group RD was significantly faster in
Group RD than Group RS. The mean duration of sensory block (838.70±164.11 min
Vs 670.20±145.16 min), motor block (804.16±148.71 min Vs 594.93±53.89 min) and
duration of analgesia (1193.80±223.11 min Vs 828.23±136.30 min) were significantly
longer in Group RD compared to Group RS. The incidence of side effects in both
groups were comparable.
Conclusion
From this study, it can be concluded that addition of Dexmedetomidine 0.75 mcg/
kg to 0.5% Ropivacaine results in early onset of sensory and motor blockade,
prolongation of duration of sensory and motor blockade and duration of analgesia
postoperatively without any significant side effects.
KEY WORDS
Analgesia, Brachial plexus block, Dexmedetomidine, Motor block, Ropivacaine,
Sensory block
Description
Sharma S, Shrestha A, Koirala M
Department of Anaesthesiology
Tribhuvan University Teaching Hospital
Maharajgunj Medical Campus, Institute of Medicine
Maharajgunj, Kathmandu, Nepal
Keywords
Analgesia, Brachial plexus block, Dexmedetomidine, Motor block, Ropivacaine, Sensory block