scholarly journals Effect of dexmedetomidine as adjuvant in supraclavicular block for upper limb orthopedic surgeries

2017 ◽  
Vol 4 (5) ◽  
pp. 1510 ◽  
Author(s):  
Dixitkumar B. Modh ◽  
Manthan Parmar ◽  
Shilpin Solanki
Keyword(s):  
Upper Limb ◽  
Motor Block ◽  
Demographic Data ◽  
Total Duration ◽  
Hemodynamic Parameters ◽  
Physical Status ◽  
Analgesic Requirement ◽  
Respiratory Parameters ◽  
Supraclavicular Block ◽  
Group D

Background: Dexmedetomidine has anxiolytic, sedative, hypnosis, analgesic, antisialogogue and sympatholytic properties which render it suitable as an adjuvant. Hence this study was aimed to prove its efficacy as an adjuvant to lignocaine and bupivacaine for supraclavicular block in patients undergoing orthopedic upper limb surgeries. Other objectives of the study were to evaluate and compare the onset and duration of sensory and motor block as well as total analgesia, to compare effect on hemodynamic and respiratory parameters and to study any adverse effect associated with dexmedetomidine as adjuvant.Methods: Sixty patients of ASA physical status class I & II of elective upper limb forearm orthopedic surgeries were selected in our study. Patients in group NS (n=30) received 10 ml lignocaine 2% + 20 ml bupivacaine 0.5% + 1 ml normal saline for supraclavicular block and group D (n=30) received 10 ml lignocaine 2% + 20 ml bupivacaine 0.5% + 1 µg/kg of Dexmedetomidine for the same block. The onset and duration of sensory and motor block, total duration of analgesia, need of rescue analgesic postoperatively, postoperative VAS score was assessed and compared between the two groups.Results: Demographic data and surgical characteristics are comparable in both the groups. The onset of sensory and motor block was significantly lower (p <0.05) in group D than in group NS. The duration of sensory and motor block was significantly higher (p <0.01) in group D when compared to group NS. The duration of analgesic requirement postoperatively was significantly higher (p <0.01) in group D than group NS. No significant change in observations was made for hemodynamic parameters in both the groups.Conclusions: Dexmedetomidine can be considered as an adjuvant to lignocaine and bupivacaine mixture for excellent quality supraclavicular block without any side effects and provide good sedation in patients undergoing orthopedic upper limb surgeries.

scholarly journals Comparison of the Effect of Lidocaine Adding Dexketoprofen and Paracetamol in Intravenous Regional Anesthesia

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Ali Akdogan ◽  
Ahmet Eroglu
Keyword(s):  
Motor Block ◽  
Risk Group ◽  
Demographic Data ◽  
Hemodynamic Effects ◽  
Intravenous Anesthesia ◽  
Intravenous Regional Anesthesia ◽  
Significant Difference ◽  
Dexketoprofen Trometamol ◽  
Analgesia Requirement ◽  
Group D

Objective.Comparison of dexketoprofen and paracetamol added to the lidocaine in Regional Intravenous Anesthesia in terms of hemodynamic effects, motor and sensorial block onset times, intraoperative VAS values, and analgesia requirements.Method.The files of 73 patients between 18 and 65 years old in the ASA I-II risk group who underwent hand and forearm surgery were analyzed and 60 patients were included in the study. Patients were divided into 3 groups: Group D (n=20), 3 mg/kg 2% lidocaine and 50 mg/2 mL dexketoprofen trometamol; Group P (n=20), 3 mg/kg 2% lidocaine and 3 mg/kg paracetamol; Group K (n=20), 3 mg/kg 2% lidocaine. Demographic data, motor and sensorial block times, heart rate, mean blood pressure, VAS values, and intraoperative and postoperative analgesia requirements were recorded.Results.Sensorial and motor block onset durations of Group K were significantly longer than other groups. Motor block termination duration was found to be significantly longer in Group D than in Group K. VAS values of Group K were found higher than other groups. There was no significant difference in VAS values between Group D and Group P. Analgesia requirement was found to be significantly more in Group K than in Group P. There was no significant difference between the groups in terms of heart rates and mean arterial pressures.Conclusion.We concluded that the addition of 3 mg/kg paracetamol and 50 mg dexketoprofen to lidocaine as adjuvant in Regional Intravenous Anesthesia applied for hand and/or forearm surgery created a significant difference clinically.

scholarly journals Comparative study of clinical efficacy and safety of intrathecal isobaric ropivacaine 0.75% with fentanyl versus isobaric ropivacaine 0.75% alone for caesarean

2020 ◽  
Vol 7 (1) ◽  
pp. 1
Author(s):  
Pushpal Gandhi ◽  
Mahendra Agrawal ◽  
Bhavika Agrawal ◽  
Simarn Behl
Keyword(s):  
Caesarean Section ◽  
Adverse Effects ◽  
Comparative Study ◽  
Clinical Efficacy ◽  
Total Duration ◽  
Sensory Block ◽  
Hemodynamic Parameters ◽  
Efficacy And Safety ◽  
Physical Status ◽  
Significant Difference

<p><strong>Background: </strong>Compare the clinical efficacy and safety of intrathecal isobaric ropivacaine 0.75% with fentanyl, 10 mcg vs isobaric ropivacaine 0.75% alone for caesarean section.</p><p><strong>Methods: </strong>Two hundred patients were considered eligible for the study of which one hundred and sixty-eight patients undergoing caesarean section under spinal anesthesia and were included in the study. Parturient to ASA physical status I-II scheduled for caesarean section were randomly selected for the study and are divided into group of 84 each.<strong></strong></p><p><strong>Results: </strong>There was significant difference in sensory block duration at T<sub>10</sub> (min) and total duration of analgesia (min) in both groups. This difference between two group’s was not significant. Adverse Effects in group RF 5 (5.9%) patients had hypotension and 2 (2.3%) bradycardias in group R 3 (3.5%) patient had hypotension.<strong></strong></p><p><strong>Conclusions: </strong>Hemodynamic parameters were comparable in both the groups. Total duration of analgesia and sensory block duration at T<sub>10</sub> was significantly shorter with ropivacaine (with saline) compared to ropivacaine with fentanyl.</p>

Randomised Study Comparing the use of Propofol Versus Dexmedetomidine as a Sedative Agent for Patients Presenting for Lower Gastrointestinal Endoscopy

2020 ◽  
Vol 15 (1) ◽  
pp. 61-66
Author(s):  
Sameh A. Ahmed ◽  
Nehad Hawash ◽  
Fatma H. Rizk ◽  
Mahmoud Elkadeem ◽  
Mohamed Elbahnasawy ◽  
...  
Keyword(s):  
Maintenance Dose ◽  
Demographic Data ◽  
Loading Dose ◽  
Hemodynamic Parameters ◽  
Traditional Use ◽  
Randomised Study ◽  
Sedative Agent ◽  
Significant Difference ◽  
Group D ◽  
Positive Effect

Objectives:: Dexmedetomidine, the alpha 2 agonist sedative and an analgesic agent may be beneficial in sedation for endoscopic intervention. Our aim was to compare the use of dexmedetomidine versus the traditional use of propofol as a sedative agent for colonoscopies. Methods:: This study included 100 patients presenting for elective colonoscopy under sedation with random and equal allocation of patients into two groups; group P, in which patients received propofol in a loading dose of 1.5 mg/kg and maintenance dose of 0.5 mg/kg/hr, and group D, in which patients received dexmedetomidine at a loading dose of 1ug/kg and maintenance dose of 0.5 ug/kg/hr. In addition to the demographic data, time to recovery, time of discharge, and endoscopist rating were measured. Also, the hemodynamic parameters were recorded, and also the incidence of postoperative complications. Results:: The basic patients' characteristics, time to recovery, and time of discharge were comparable between the two groups. Moreover, the endoscopist did not significantly report more convenient procedure with one group over the other. Also, there was no significant difference in hemodynamic parameters or in the incidence of complications between the two studied groups. However the use of dexmedetomidine decreased the incidence of hypoxemia. Conclusion:: The use of dexmedetomidine seems to have a similar effect to the use of propofol as a sedative agent for lower GIT endoscopy with the positive effect of dexmedetomidine in decreasing the incidence of perioperative hypoxemia.

scholarly journals A PROSPECTIVE, RANDOMIZED, DOUBLE BLINDED, CONTROLLED STUDY TO EVALUATE THE EFFICACY OF DEXMEDETOMIDINE 50µg AND DEXAMETHASONE 8mg AS AN ADJUVANT TO ROPIVACAINE 0.5% FOR SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK IN ELECTIVE UPPER LIMB SURGERIES.

2020 ◽  
pp. 63-65
Author(s):  
Kavya Madhyastha ◽  
Shashikala T K
Keyword(s):  
Brachial Plexus ◽  
Upper Limb ◽  
Motor Block ◽  
Total Duration ◽  
Saline Group ◽  
Primary Objective ◽  
Controlled Study ◽  
Supraclavicular Brachial Plexus Block ◽  
Double Blinded ◽  
Plexus Block

BACKGROUND: Brachial Plexus Blocks are the popular choice of anaesthesia technique as a part of day care surgeries for upper limb. In this study, efficacy of non opioid adjuvants Dexamethasone and Dexmedetomidine has been evaluated. MATERIALS AND METHODS: 90 ASA class I and II patients undergoing elective upper limb surgeries were randomly divided into three groups of 30 each. Group C received 0.5% Ropivacaine 28ml with 2ml normal saline, Group DX received 0.5% Ropivacaine 28ml with 8mg Dexamethasone and Group DM received 0.5% Ropivacaine 28ml with Dexmedetomidine 50µg. The primary objective was to know the sensory and motor block onset, total sensory and motor block duration, total duration of analgesia. Secondary parameters were mean arterial pressure, peripheral saturation and sedation score. Statistical methods were carried out through SPSS for Windows(version 16.0) RESULTS: The sensory and motor block onset was earlier in Group DM compared to Group C and Group DX, while it was later in Group DX compared to Group C. The mean TSBD, TMBD and TDA was longer in Group DX(746.66min, 677.83min, 800.16min) compared to Group C (361.33min, 303.66min, 411.16min)and Group DM(686.33min, 593.5 min, 701.83min). There was no significant change in MAP, SpO2 and sedation scores.

scholarly journals Comparative study of ropivacaine alone versus ropivacaine with dexamethasone in supraclavicular brachial plexus block

2017 ◽  
Vol 4 (12) ◽  
pp. 3879 ◽  
Author(s):  
Sampathi Shiva Krishna ◽  
G. Praveen Chandra ◽  
C. Krishna Chaithanya
Keyword(s):  
Brachial Plexus ◽  
Upper Limb ◽  
Motor Block ◽  
Statistical Difference ◽  
Brachial Plexus Block ◽  
Total Duration ◽  
Duration Of Surgery ◽  
Supraclavicular Brachial Plexus Block ◽  
Plexus Block ◽  
Very High

Background: Brachial plexus block is often used either as an adjuvant to general anesthesia (GA) or as a sole anesthesia modality. Supraclavicular brachial plexus block is preferred for its rapid onset, reliable anesthesia and as a safe technique for any surgery in the upper extremity that does not involve the shoulder. We have attempted to undertake this study to compare the haemodynamic, sensory and motor effects of the anaesthetic effect of Ropivacaine alone and Ropivacaine along with Dexamethasone in Supraclavicular Brachial Block in upper limb surgery.Methods: The total duration of surgery was also comparable in both groups. The onset of the sensory and the motor block in bother the groups were similar to each other with no statistical difference, but there was a very high significance in the duration of both sensory and motor block within both the groups.Results: The total duration of surgery was also comparable in both groups. The onset of the sensory and the motor block in bother the groups were similar to each other with no statistical difference, but there was a very high significance in the duration of both sensory and motor block within both the groups.Conclusions: Dexamethasone added to ropivacaine in supraclavicular brachial block for upper limb surgery significantly shortens the onset time and prolongs the duration of sensory and motor blocks without producing sedation in patients.

scholarly journals A prospective randomized clinical study to compare the efficacy of 0.25% bupivacaine with clonidine and 0.25% levobupivacaine with clonidine in supraclavicular brachial plexus block for upper limb surgeries

2021 ◽  
Vol 8 (4) ◽  
pp. 543-550
Author(s):  
Abhishek R ◽  
Arun Aravind ◽  
Shankaranarayana P
Keyword(s):  
Brachial Plexus ◽  
Upper Limb ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Sensory Block ◽  
Racemic Mixture ◽  
Hemodynamic Parameters ◽  
Randomized Clinical Study ◽  
Supraclavicular Brachial Plexus Block ◽  
Plexus Block

:Bupivacaine is an amide local anesthetic, available as a racemic mixture of Dextro and Levorotatory Isomers. Due to its rapid onset and longer duration of anesthesia, It is routinely preferred in various regional anesthetic techniques. However, it is associated with serious cardiovascular and neurological toxicity. Its pure S- enantiomer, Levobupivacaine having similar pharmacological profile is known to have lesser cardiovascular and CNS toxicity. Combining adjuvants like clonidine, a centrally acting partial alpha-2-adrenergic agonist to improve quality of anesthesia is common practice. Hence, the aim of our study is to compare efficacy and safety of 0.25% Levobupivacaine and 0.25% Bupivacaine when combined with clonidine in supraclavicular brachial plexus block for upper limb surgeries.Eighty patients aged between 18 to 60 years with ASA physical status I-II, scheduled for elective upper limb surgeries under were randomized into two groups. Peripheral nerve stimulator guided Supraclavicular brachial plexus block was administered. Group BC received 30ml of 0.25% Bupivacaine plus 1µg/kg Clonidine and Group LC 30ml of 0.25% Levobupivacaine plus 1µg/kg Clonidine. The time of onset of sensory and motor block, duration of sensory and motor block, perioperative hemodynamic parameters, postoperative pain for 24hours and adverse effects were studies.Group LC had faster onset of sensory block (p= 0.014) as well as faster onset of motor block (p= 0.012) compared to group BC. However, durations of sensory block and motor block were statistically not significant in both the groups (p&#62;0.05). Perioperative hemodynamic parameters and assessment of pain during 24 hours of post operative period were comparable and statistically not significant.1mcg/kg of clonidine used as an adjuvant to 30ml of 0.25% Levobupivacaine produces faster onset of sensory and motor block compared to 0.25% Bupivacaine in supraclavicular brachial plexus block. However, similar anesthetic efficacy in terms of duration of sensory and motor block, hemodynamics and postoperative analgesia were observed.

scholarly journals Comparative study between dexamethasone and dexmedetomidine in supraclavicular block

2018 ◽  
Vol 5 (1) ◽  
pp. 57 ◽  
Author(s):  
Mandeep Kaur ◽  
Amit Lakhani ◽  
A.M. Hashia
Keyword(s):  
Informed Consent ◽  
Adverse Events ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Sensory Block ◽  
Local Anaesthetics ◽  
Supraclavicular Block ◽  
Plexus Block ◽  
Group D

Background: With the addition of adjuvants to local anaesthetics the onset, duration and quality of brachial plexus block improves to a marked extent. The intent of this study was to compare onset, duration of sensory and motor block along with duration of analgesia when an α-2 agonist dexmedetomidine or a steroid dexamethasone was added to a mixture of 2% lignocaine with adrenaline and 0.5% bupivacaine.Methods: 100 patients belonging to ASAI and ASAII were included in the study scheduled for upper limb surgeries after taking informed consent. These patients were divided in to two groups having 50 patients in each group. Group D received 20ml of 2% lignocaine with adrenaline plus 18ml of 0.5% bupivacaine plus 50μg of dexmedetomidine and group X received 20ml of 2% lignocaine with adrenaline plus 18ml of 0.5% bupivacaine plus 8mg of dexamethasone. Onset of sensory and motor block, duration of block, quality of intraoperative analgesia and duration of analgesia were recorded.Results: Our study revealed similar onset of sensory block in group D and X. Group D showed early onset and longer duration of motor block compared to group X. Intraoperative haemodynamics were similar in both groups.Conclusions: Our study concludes that using dexmedetomidine as adjuvant prolongs the duration of block and postoperative analgesia compared to dexamethasone with minimal or negligible adverse events.

Comparison of clonidine and tramadol in supraclavicular block as adjuvant in upper limb surgery

2019 ◽  
Vol 12 (2) ◽  
pp. 116-121
Author(s):  
Bhavna H Sojitra ◽  
◽  
Malti J Pandya ◽  
Ronak Nagoria ◽  
◽  
...  
Keyword(s):  
Upper Limb ◽  
Upper Limb Surgery ◽  
Supraclavicular Block

scholarly journals Comparison between Single- and Double-Injection Technique for Ultrasound-Guided Supraclavicular Block: A Randomized Controlled Study

2021 ◽  
pp. 1-6
Author(s):  
Suresh Kumar Vallapureddy ◽  
Gajanan Fultambkar ◽  
V. Rajeswar Rao ◽  
Vinay Kukreja ◽  
Rammohan Gurram ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Local Anesthetic ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Demographic Data ◽  
Controlled Study ◽  
Injection Technique ◽  
Double Injection ◽  
Performance Time ◽  
Plexus Block

<b><i>Background:</i></b> The supraclavicular approach to brachial plexus block is a commonly employed regional anesthesia technique for providing surgical anesthesia and postoperative analgesia for patients undergoing upper limb fractures. With ultrasound (US) guidance, the success rate of the block is increased, and complications like pneumothorax and vascular puncture are minimized. The block can be performed using single injection at the corner pocket or double injection, that is, half of the drug at the corner pocket and the remaining half at the cluster of brachial plexus divisions. <b><i>Methods:</i></b> After institutional ethics committee approval, we randomized 40 patients scheduled with fractures for elective upper extremity surgery under US-guided supraclavicular brachial plexus block. Twenty patients received 30 mL of local anesthetic at the corner pocket (group SI), and 20 patients received 30 mL of local anesthetic using the dual-injection technique in divided doses (group DI). Demographic data, time to block performance, time to sensory and motor block, total anesthesia-related time (TART), block success, and failure were compared between both groups. <b><i>Results:</i></b> The demographic data were comparable between both groups. The DI group had a significantly faster onset than the SI group (<i>p</i> = 0.0172). There was a statistically significant lesser performance time in group SI than in group DI (<i>p</i> &#x3c; 0.034). The sensory and motor block achieved was comparable between both groups. <b><i>Conclusion:</i></b> The success rates in both the SI and DI techniques are comparable. The DI technique results in a faster onset and hence a shorter TART; however, it may not be clinically relevant.

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