KUMJ | VOL. 17 | NO. 3 | ISSUE 67 | JULY-SEPT. 2019

Effect of Dexmedetomidine with Ropivacaine in Supraclavicular Brachial Plexus Block
Sharma S, Shrestha A, Koirala M

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.
Keyword : Analgesia, Brachial plexus block, Dexmedetomidine, Motor block, Ropivacaine, Sensory block