A prospective Randomized Double Blinded Study to Evaluate the Efficacy of Dexmedetomidine 50 ?g Intravenously and Perineurally as An Adjunct to 0.5% Ropivacaine for Supraclavicular Brachial Plexus Block.

Shashikala TK; Kavya Madhyastha

Author(s)

Shashikala TK Department of Anesthesiology, Mysore Medical College & Research Institute, Irwin Road, Mysuru, Karnataka 570001, India

Kavya Madhyastha Department of Anesthesiology, Mysore Medical College & Research Institute, Irwin Road, Mysuru, Karnataka 570001, India

Abstract

Background: Dexmedetomidine, highly selective a2 agonist is used as an effective adjuvant to various local anesthetics in regional anesthesia. We have conducted this tsudy to know the efficacy of dexmedetomidine through two routes i.e intravenous and perineural routes with ropivacaine for supraclavicular brachial plexus block in elective forearm surgeries. Methodology: After the institutional ethical committee clearance, 60 patients aged Correspondence: Dr Shashikala between 18 to 60 years, belonging to ASA class I and II were randomly divided into TK, No 156, 1st cross, 4th main, two groups of 30 each after a detailed informed consent. Group DPN received 0.5% Bank colony, Bogadhi, Mysore - ropivacaine 28 ml + 2 ml of dexmedetomidine 50 µg perineurally and 100 ml of 0.9% 570026 (India); normal saline intravenously. Group DIV received 0.5% ropivacaine 28 ml + 2 ml 0.9% Phone: 9480057506; normal saline perineurally and 50 µg of Dexmedetomidine in 100 ml of 0.9% normal E-mail: drshi72@gmail.com saline intravenously. Primary objectives was to know the time of sensory onset, motor onset, time for complete motor and sensory block, total duration of sensory and motor block and total duration of analgesia. Secondary objectives were hemodynamic parameters, sedation scores and adverse events. Statistical methods were carried out through the SPSS for Windows (version 16.0) Results: The demographic profile of the patients like age, sex, height, weight, BMI were similar in both groups. The sensory and motor onset time as well as time for complete sensory and motor block was earlier in Group DPN than Group DIV. The sensory block duration was prolonged in Group DPN (686.33 ± 52.22 min) compared to Group DIV (371 ± 38.98 min) [p < 0.001]. The motor block duration was also significantly prolonged in Group DPN (593.50 ± 58.12 min) compared to Group DIV (319.50 ± 26.47 min) [p < 0.001]. The total duration of analgesia was also significantly prolonged in Group DPN (701.83 ± 44.92 min) compared to Group DIV (405.16 ± 30.86 min)[p < 0.001]. Two patients had bradycardia and one patient had hypotension in Group DIV. Ramsay sedation scores in both the groups were < 3. Conclusion: Dexmedetomidine is an excellent adjuvant to ropivacaine for supraclavicular block. Perineural dexmedetomidine ofers a better block quality and a prolonged duration of analgesia compared to intravenous dexmedetomidine with minimal side efects.

Publication Details

Page(s) 413-419

DOI DOI not available

Published Journal: Anaesthesia, Pain and Intensive Care, Volume: 21, Issue: 4, Year: 2017

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