INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH | 2021
COMPARISON OF EFFECT OF 0.25% BUPIVACAINE ALONE AND 0.25% BUPIVACAINE WITH DEXMEDETOMIDINE IN BRACHIAL PLEXUS BLOCK THROUGH SUPRACLAVICULAR APPROACH
Abstract
BACKGROUND AND AIM:Brachial plexus block is a safe, effective, low-cost anesthesia with good postoperative analgesia. Adjuvants to local\nanesthetics may enhance the quality and duration of analgesia. The aim of the study was to study the ef\uf001cacy of a combination of 0.25%\nbupivacaine alone versus 0.25% bupivacaine and dexmedetomidine in brachial plexus block by supraclavicular approach.\nMETHODS: This is a prospective double-blind study conducted on sixty patients of ASA1 and ASA2 posted for upper limb surgeries, randomized\nin a double-blind fashion into two groups. Group A (N-30) received 34ml of 0.25% bupivacaine with 0.5ml of distilled water and group B (N-30)\nreceived 0.5ml dexmedetomidine (50 μg) with 34ml of 0.25% bupivacaine as supraclavicular brachial plexus block with help of a nerve stimulator.\nOnset and recovery time of sensory and motor block, duration of analgesia, sedation scores, quality of block, and side effects compared in both\ngroups.\nRESULTS: Baseline characteristics were well matched in both groups. The intraoperative hemodynamic recording was done at 15 min time\nintervals from the administration of the drugs. There was a reduction in heart rate, systolic blood pressure, and diastolic blood pressure 30 mins\nonwards in both groups. There was no signi\uf001cant difference in the onset of sensory and motor blocks. Duration of sensory block was 299.57 ± 35.94\nmins in Group A and 782.2 ± 82.76 mins in Group B, duration of motor block was 272.17 ± 37.31 mins versus 755.63 +/- 86.6 mins respectively,\ntotal duration of analgesia was 321 ± 35.46 mins versus 815.80 +/- 88.1 mins respectively. Ramsay sedation score was similar at arrival in both\ngroups but in post-op, the score of 3 was noted in 0% (0/ 30) in Gr A and 93.3% (28/ 30) in Gr B . Quality of analgesia was also better in Group B.\nThere were no signi\uf001cant adverse events noted in both groups.\nCONCLUSION: This double-blind Randomized Controlled study showing the combination of dexmedetomidine 50 μg with 34ml of 0.25%\nbupivacaine is better than 0.5ml of distilled water with 34ml of 0.25% bupivacaine in the duration of sensory and motor block, with better sedation\nand quality of analgesia with the good safety pro\uf001le in brachial plexus block by supraclavicular approach.