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Dexmedetomidine addition to local anesthetics profoundly extends the effect of ultrasound-guided supraclavicular block in limb surgeries.
According to the findings of a recent comparative study, using dexmedetomidine as an adjunct to bupivacaine and xylocaine with adrenaline had early commencement of sensory and motor block and considerably extended the analgesia duration in people scheduled to undergo upper limb surgery. Investigators undertook this analysis to assess the impact of combination of dexmedetomidine and local anesthetics in ultrasound-guided supraclavicular brachial plexus block in limb surgery.
A total of 44 subjects (18-60 years of age) were randomly segregated into two groups: Group I:(Dexmedetomidine group, n=22) was given 2% xylocaine and 0.5% bupivacaine with 28 ml adrenaline plus 2 ml (1 mcg/ml) dexmedetomidine while Group II (Non-dexmedetomidine group, n=22) was given 2% xylocaine and 0.5% bupivacaine with 28 ml adrenaline plus 2 ml normal saline.
Comparison of the demographics, analgesia duration, adverse events related to the drugs, the onset of motor and sensory block, and hemodynamic parameters were compared. To investigate sensory and motor blockades, the Pin-prick test and the modified Bromage scale were utilized. Utilizing visual analogue scale (VAS), the severity of pain was assessed. Statistical analysis was done using SPSS v16.
Group I exhibited a shorter median time for the onsets of motor and sensory blocks and longer analgesia duration when compared to group II, as shown in table 1.
In group A, one subject experienced hypertension, two subjects had bradycardia, and two patients had anxiety during the procedure. In group B, three subjects were anxious. Hence, with the addition of dexmedetomidine (a highly selective alpha-2 receptor agonist) to local anesthetics in supraclavicular block, the onset of motor and sensory blocks was considerably faster and the analgesia duration also got prolonged.
Journal of Patan Academy of Health Sciences
Dexmedetomidine as an adjunct to bupivacaine and xylocaine with adrenaline in ultrasound guided supraclavicular brachial plexus block in upper limb surgeries
Alisha Shrestha et al.
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