scholarly journals COMPARISON OF CLONIDINE AND DEXMEDETOMIDINE AS AN ADJUVANT TO 0.5% BUPIVACAINE IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK: A RANDOMISED PROSPECTIVE DOUBLE-BLIND STUDY

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Kushal Jethani ◽  
Preeti Sahu ◽  
Seethal Ann
Keyword(s):  
Brachial Plexus ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Double Blind Study ◽  
Nerve Blocks ◽  
Rescue Analgesia ◽  
Significant Difference ◽  
Supraclavicular Brachial Plexus Block ◽  
Plexus Block ◽  
Group D

Background and Objectives: Alpha-2 agonists are used as adjuvant with local anaesthetic agents to prolong the duration of spinal, epidural and peripheral nerve blocks as well as to prolong the duration of post operative analgesia. We performed a study to compare clonidine(1ug/kg) and dexmedetomidine (1ug/kg) as an adjuvant to 0.5% bupivacaine in supraclavicular brachial plexus block. Methods: Eighty ASA I and II patients scheduled for elective upper limb orthopaedic surgeries under supraclavicular brachial plexus block were divided into two  groups(n=25 each) in a randomized, double-blinded fashion. Group C received clonidine 1 μg/kg and Group D received dexmedetomidine 1 μg/kg added to bupivacaine 0.5% (30 cc). Onset and recovery time of sensory and motor block, as well as duration of analgesia were studied in both the groups. Results: Duration of sensory block and motor block was 220.12 ±50.3 and 280.1± 20.12 min respectively in group C, while it was 410.34± 60.12 and 460.4 ± 50.56 min respectively in group D and hence both were significantly prolonged in group D.  No statistically significant difference was seen in onset of sensory and motor block between the two groups. The duration of analgesia i.e. time to requirement of rescue analgesia was 270.4± 56.7 mins and 452.7 ±64.23 mins in group C and D respectively and  this difference was statistically significant (P=0.001). Conclusion: Addition of dexmedetomidine to bupivacaine 0.5% in supraclavicular brachial plexus block prolonged the duration of sensory and motor block as well as the duration of analgesia when compared with clonidine. Keywords: Clonidine, dexmedetomidine, supraclavicular block

scholarly journals COMPARISON OF FENTANYL AND DEXMEDETOMIDINE AS AN ADJUVANT TO BUPIVACAINE IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK: A RANDOMIZED-DOUBLE BLIND PROSPECTIVE STUDY

2016 ◽  
Vol 9 (5) ◽  
pp. 74 ◽  
Author(s):  
Daisy Karan ◽  
Swastika Swaro ◽  
Swarna Banerjee
Keyword(s):  
Brachial Plexus ◽  
Upper Limb ◽  
Brachial Plexus Block ◽  
Nerve Blocks ◽  
Double Blind ◽  
Rescue Analgesia ◽  
Sensory Blockade ◽  
Significant Difference ◽  
Supraclavicular Brachial Plexus Block ◽  
Plexus Block

ABSTRACTObjectives: Supraclavicular block of brachial plexus provides complete and reliable anesthesia for upper limb surgeries. Using adjuvant to localanesthetics, blocks can be prolonged to long durations. Peripheral nerve blocks thus help in avoiding the hazards of general anesthesia. We comparedthe sensory blockade, motor blockade, and duration of analgesia with the addition of fentanyl or dexmedetomidine to bupivacaine for supraclavicularbrachial plexus block.Methods: A total of 50 American Society of Anesthesiologist’s Physical Status I and II patients scheduled for elective upper limb surgeries undersupraclavicular brachial plexus block were divided into two equal groups in a randomized double-blinded fashion. Group BF received 30 mlbupivacaine with fentanyl 50 µg and Group BD received 30 ml bupivacaine with dexmedetomidine 50 µg. The characteristics for anesthesia andanalgesia were assessed in both groups.Results: Duration of sensory and motor block was 363.4±38.36 minutes and 357±36.77 minutes, respectively, in Group BF while it was452.96±77.12 minutes and 441.52±48.46 minutes in Group BD. There was a statistically significant difference in onset of sensory and motorblock between the two groups. The duration of analgesia (time to requirement of rescue analgesia) in Group BD was longer than in Group BF(471.44±65.88 minutes vs. 366.48±38.02 minutes) with (p<0.0001). There were minimum hemodynamic disturbances and side effects in any groupexcept for Grade 3 sedation score which was more in Group BD.Conclusion: Dexmedetomidine, when added to bupivacaine in supraclavicular brachial plexus block, enhanced the duration of sensory and motorblock and also the duration of analgesia, more than when fentanyl was added to bupivacaine.Keywords: Fentanyl, Dexmedetomidine, Bupivacaine, Supraclavicular brachial block.

Effect of Dexamethasone on The Duration of Analgesia for Supraclavicular Brachial Plexus Block

KYAMC Journal ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 199-203
Author(s):  
Md Rafiqul Islam ◽  
Laila Yesmin ◽  
Md Pervez Rahman ◽  
ABM Shafiul Anam Khan ◽  
Md Miraj Hossain ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Onset Time ◽  
Double Blind Study ◽  
Double Blind ◽  
Significant Difference ◽  
Supraclavicular Brachial Plexus Block ◽  
Group B ◽  
Plexus Block

Background: Brachial plexus block with Bupivacaine provides effective intraoperative anesthesia and analgesia. The use of dexamethasone along with local anesthetic has been shown to improve the duration of analgesia. Objective: To observe the effect of Dexamethasone on the duration of analgesia for Supraclavicular Brachial plexus block. Materials and Methods: A prospective, double-blind study was undertaken in patients scheduled for upper limb surgeries under supraclavicular brachial plexus block. patients were randomly divided into two groups, Group (BD) and B. Group B received 28 ml of 0.25% bupivacaine with 2 ml normal saline while Group BD received 28 ml of 0.25% bupivacain with 2ml (8mg) dexamethasone for supraclavicular brachial plexus block. The groups were compared regarding quality of sensory and motor blockade. All the information was recorded in data collection sheet. Data was processed and analysed with the help of computer program SPSS and Microsoft excel. Results: There was no significant difference between groups in respect of demographic and American Society of Anaesthesiologist (ASA) status. Mean age was found to 34.7±8.53 years. In Group (BD) , 63.3% were ASA I and 36.6% were ASA II. In Group B, 60% were ASA I and 40% were ASA II. It has become evident that satisfactory anaesthesia can be made possible by addition of adjuvant to local anaesthetic in brachial plexus block (in Group-BD). onset of sensory block was faster in Group BD (8.17 ± 1.4 min) than Group B (9.12 ± 1.68 min). Similarly mean onset time of motor block in group A was 12.26 ± 3.96 min, and 11.58 ± 3.68 min in group B. Our study shows that duration of motor block was 408.68±26.96 min and 380.26 ± 24.11 min in group BD and Group B respectively. Conclusion: There was significantly prolonged duration of analgesia in addition of Dexamethasone without any unwanted effects. KYAMC Journal Vol. 11, No.-4, January 2021, Page 199-203

Comparative study of (0.5%) levobupivacaine and (0.75%) ropivacaine in supraclavicular brachial plexus block by lateral approach

2017 ◽  
Vol 5 (6) ◽  
pp. 2426
Author(s):  
Jitesh Kumar ◽  
. Sweta ◽  
Kumari Kanak Lata ◽  
B. K. Prasad ◽  
V. K. Gupta
Keyword(s):  
Brachial Plexus ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Sensory Block ◽  
Lateral Approach ◽  
Controlled Study ◽  
Upper Limb Surgery ◽  
Significant Difference ◽  
Supraclavicular Brachial Plexus Block ◽  
Plexus Block

Background: As compared to general anaesthesia, brachial plexus block for upper limb surgery gives fewer side effects and better postoperative analgesia. The objective of this study was to evaluate the effects of 0.5% levobupivacaine and compare it with 0.75% ropivacaine.Methods: For this prospective randomized, controlled study, 60 patients of both sexes of ASA grade 1 and 2 were enrolled and divided into two groups and supraclavicular brachial plexus block was performed by lateral approach using 30 ml of 0.5% levobupivacaine and 0.75% ropivacaine. The onset of sensory and motor block, duration of sensory and motor block and analgesia and possible adverse events were recorded.Results: No statistically significant difference was observed in the onset of sensory block in both groups. Onset of motor block was significantly faster in levobupivacaine group (P<0.05). Duration of sensory block, motor block and analgesia was significantly longer in levobupivacaine group (P<0.05).Conclusions: 0.5% levobupivacaine is better alternative to 0.75% ropivacaine in brachial plexus block in term of early onset of sensory block and long duration of analgesia.

scholarly journals A Prospective Study of Dexmedetomidine as an Adjuvant to Local Anaesthetic Used in Supraclavicular Block

2021 ◽  
Vol 8 (07) ◽  
pp. 345-349
Author(s):  
Paidikondala L.R.N.N. ◽  
Kommula Gopala Krishna ◽  
Subhamani P ◽  
Sudhir Sirkar P
Keyword(s):  
Brachial Plexus ◽  
Local Anaesthetic ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Sensory Block ◽  
Postoperative Pain Management ◽  
Control Group ◽  
Rescue Analgesia ◽  
Supraclavicular Brachial Plexus Block ◽  
Plexus Block

BACKGROUND To improve the quality of block (sensory and motor characteristics), postoperative pain management and reduce large doses of local anaesthetics, various adjuvants are used with local anaesthetic agents. We have evaluated dexmedetomidine as an adjuvant to 0.5 % ropivacaine in supraclavicular brachial plexus block in terms of onset and duration of sensory and motor block & duration of postoperative analgesia. METHODS This is a prospective randomised comparative study. 60 patients who were admitted for elective surgeries of the lower arm, at the level of elbow, forearm & hand were enrolled. They were divided in to two groups of 30 patients each as follows - group RD: supraclavicular brachial plexus block given with 30 mL of 0.5 % ropivacaine + 1 mL (100 μg) of dexmedetomidine. Group RC: supraclavicular brachial plexus block given with 30 mL of 0.5 % ropivacaine + 1 mL of normal saline. Various parameters like onset times and durations of sensory and motor block, duration of analgesia, total analgesic needed, and side-effects were recorded for each patient. RESULTS The time of onset of sensory and motor block was significantly early in dexmedetomidine group than in control group. The duration of sensory and motor block was significantly prolonged in group RD as compared to group RC. The duration of sensory block was 724.18 + 73.26 min in group RD (GD) and 582.16 + 93.12 min. in group RC (GC). The duration of analgesia was significantly prolonged in group RD. CONCLUSIONS Addition of dexmedetomidine as an adjuvant to ropivacaine is associated with early onset of sensory and motor block. The duration of sensory and motor block was prolonged. The duration of analgesia was prolonged and patients required less rescue analgesia. The use of dexmedetomidine was associated with reversible bradycardia and sedation score was less KEYWORDS Ropivacaine, Dexmedetomidine, Adjuvant, Supraclavicular Brachial Plexus Block

scholarly journals A Prospective Randomized Study to compare Levobupivacaine and Ropivacaine in Patients Undergoing Forearm Orthopaedic Surgeries under Ultrasound-Guided Supraclavicular Brachial Plexus Block

2021 ◽  
Vol 15 (7) ◽  
pp. 2075-2081
Author(s):  
Wasim Khursheed Mir ◽  
Vipin Kumar Varshney ◽  
Md Shahbaz Alam ◽  
Prateek Singh ◽  
G.S. Jheetay ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Randomized Study ◽  
Prospective Randomized Study ◽  
Ultrasound Guided ◽  
Onset Of Action ◽  
Significant Difference ◽  
Supraclavicular Brachial Plexus Block ◽  
Plexus Block

Background: Brachial plexus block utilizing ultrasound imaging has now become either adjuvant to general anaesthesia (GA) or as a mainstay anaesthesia modality. There are fewer studies comparing the effects of ropivacaine and levobupivacaine for supraclavicular brachial plexus block. The aim of this study was to do a prospective randomized study to compare 0.5% Levobupivacaine and 0.5% Ropivacaine in patients undergoing forearm orthopaedic surgeries under Ultrasound-Guided Supraclavicular Brachial Plexus Block. Materials and Methods: A total of 56 patients were enrolled and randomized into two groups. Group R with 28 patients was given 30mL of 0.5% Ropivacaine and Group L with 28 patients were given 30 mL of 0.5% Levobupivacaine, drugs were used for giving supraclavicular block under ultrasound. Parameters assessed were onset and duration of sensory and motor block, duration of analgesia, and any adverse events. After administration of block, the block characteristics were assessed every 5mins till the onset of the complete blockade, then hourly till the effect of the block. Data between the groups were analysed using SPSS 25.0 software. Results: Demographically both the groups were comparable in the study. The study shows that there was a statistically significant difference in onset of sensory block in Levobupivacaine and Ropivacaine (7.54 mins ± 2.10 vs 8.55 mins ± 2.08), similarly there was the difference in onset of motor block in Levobupivacaine 12.95 mins ± 2.30 vs Ropivacaine 14.07 mins ± 2.22. The duration of analgesia was more in the group of patients Levobupivacaine (9.98 hours ± 4.88) Ropivacaine (8.03 hours ± 3.58) Conclusion: the onset of action of sensory and motor was early in Levobupivacaine group with faster recovery of motor function as compared to the equivalent dose of Ropivacaine. Levobupivacaine has a better profile in terms of duration of analgesia. Keywords: Brachial plexus block, ropivacaine, levobupivacaine, supraclavicular brachial plexus block, ultrasound guidance

scholarly journals Comparative Study for Anaesthetic Quality with the Addition of Clonidine, Fentanyl or Dexmedetomidine to 0.5℅ Ropivacaine in Supraclavicular Brachial Plexus Block at a Tertiary Hospital

2021 ◽  
pp. 1-3
Author(s):  
Naveen P
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Block ◽  
Tertiary Hospital ◽  
Motor Blockade ◽  
Rescue Analgesia ◽  
Sensory Blockade ◽  
Supraclavicular Brachial Plexus Block ◽  
The Difference ◽  
Plexus Block ◽  
Group D

Background: Supraclavicular Brachial plexus block also described as the “spinal of arm”, provides a rapid onset, complete, predictable, and dense anesthesia for the mid humerus, forearm and hand surgery. Brachial plexus block also causes sympathetic block with resultant improvement in blood flow, reduction in vasospasm, and edema which is more favorable for an acute hand injury and reconstructive plastic surgery. In the present study, we compared the anesthetic quality with the addition of either clonidine, fentanyl, or dexmedetomidine to 0.5℅ ropivacaine for supraclavicular brachial plexus block in regard to the onset and duration of sensory/motor block and duration of analgesia at a tertiary hospital. Material and Methods: Present study was the prospective, interventional and comparative study carried out in the department of anaesthesiology, in patients 18-60 years, ASA grade1/2, Mallampati grades 1 and 2, posted for elective upper limb surgeries. 60 patients were randomly divided into three groups, each group includes 20 patients, (Group D- Dexmedetomidine, C- Clonidine, F- Fentanyl). Results: 60 patients scheduled to undergo elective upper limb surgeries were randomly divided into three groups (Group D, C, F), each group includes 20 patients. Age, gender, ASA status, weight, height and mean duration of surgery were comparable in three groups and the difference was statistically insignificant. The difference between the onset of sensory blockade, mean time of onset of complete sensory blockade, duration of complete sensory blockade was found to be statistically significant. Intergroup analysis in groups D, C and F for the onset of sensory blockade, onset of complete sensory blockade and duration of complete sensory blockade in three different groups noted a statistically significant difference. The difference for the onset of motor blockade, the onset of complete motor blockade and duration of motor blockade was found to be statistically significant as (p<0.05), there is a difference noted between Group D, C, and F. Intergroup statistical analysis of the onset of motor blockade, the onset of complete motor blockade and duration of motor blockade between group D vs C and group D vs F were statistically significant, whereas between group C vs F it was insignificant. The duration of analgesia was prolonged in Group D, C, F and was found to be statistically significant. Intergroup analysis of duration of analgesia between three different groups. The difference between group D vs C, between group D vs F, and between-group C vs F was statistically significant. The time of 1st rescue analgesia was prolonged in Group D, C, F and was statistically significant (p<0.05). Intergroup analysis of the time of 1st rescue analgesia between three different groups. The difference between group D vs C, between group D vs F, and between group C vs F were statistically significant. Conclusion: Dexmedetomidine, clonidine added to ropivacaine shortens the onset of sensory and motor blockade, prolongs the duration of the sensory blockade as compared to fentanyl. Dexmedetomidine shortens the onset of sensory and motor blockade much more than clonidine.

scholarly journals A Comparative Clinical Evaluation of Efficacy of Tramadol As An Adjuvant To Bupivacaine En Brachial Plexus Block For Upper Limb Surgery

2017 ◽  
Vol 13 (2) ◽  
pp. 13-16 ◽  
Author(s):  
Nabin Kumar Regmi ◽  
Sangeeta Subba ◽  
Uttam Chandra Sharma
Keyword(s):  
Brachial Plexus ◽  
Upper Limb ◽  
Brachial Plexus Block ◽  
Nerve Blocks ◽  
Group I ◽  
Upper Limb Surgery ◽  
Significant Difference ◽  
Supraclavicular Brachial Plexus Block ◽  
Plexus Block

Background: In peripheral nerve blocks, adjuvants are added to local anaesthetics to improve the quality of anaesthesia and analgesia. We designed this randomized single blinded prospective study to compare the analgesic efficacy of tramadol used as an adjuvant to bupivacaine for supraclavicular brachial plexus block in patients undergoing orthopaedic surgeries of upper limb.Aim of study: In this study, we aimed to compare onset, duration and quality of analgesia along with respiratory, hemodynamic changes with tramadol as adjuvant to bupivacaine in supraclavicular brachial plexus block in the patients undergoing upper limb surgery.Method: In this prospective randomized control trial, two groups of 30 patients each were investigated. 28 ml. of 0.5% bupivacaine (plain) with 2 ml. normal saline was administered in group - I and 28 ml. of 0.5% bupivacaine (plain) with 2ml. (100 mg.) tramadol was administered in group - II. The onset of sensory and motor block, duration of analgesia, respiratory/hemodynamic parameters and post-operatively quality of analgesia via visual analogue scale were assessed.Results: The duration and quality of analgesia was significantly increased by adding tramadol in bupivacaine than bupivacaine alone (p=<0.001 and <0.001) whereas there was no statistically significant difference in onset of motor (p=>0.35) and sensory block (p=>0.75) and also hemodynamic and respiratory parameters.(HR p=>0.1, MAP p=>0.5, and SPO p=>0.5).Conclusion: The study suggests that tramadol when added to bupivacaine 2 for supraclavicular brachial plexus block enhances the quality of anaesthesia and analgesia without affecting respiratory/hemodynamic parameters.JNGMC Vol. 13 No. 2 December 2015, Page: 13-16

scholarly journals A Comparative Study Between Two Different Doses of Dexmedetomidine Combined with Ropivacaine in Ultrasound Guided Supraclavicular Brachial Plexus Block

2018 ◽  
Vol 14 (3) ◽  
pp. 127-131
Author(s):  
Jeevan Singh ◽  
Samir Shakya ◽  
Anuranjan Ghimire ◽  
Sanjay Saha ◽  
Parikshit Bikram Singh
Keyword(s):  
Brachial Plexus ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Onset Time ◽  
P Value ◽  
Double Blind ◽  
Significant Difference ◽  
Supraclavicular Brachial Plexus Block ◽  
Plexus Block ◽  
Different Doses

Background: Though, various studies have been conducted to show the efficacy of            dexmedetomidine as an adjuvant to brachial plexus block, there is no clear consensus for its optimal dose. We compared 2 different doses of dexmedetomidine (1mcg/kg Vs 2mcg/kg) with ropivaciane in USG guided brachial plexus block for the quality of anesthesia and analgesia. Materials and Methods: Fifty patients (18-50years, 50-60kgs), ASA PS I and II undergoing surgery of upper limb were enrolled in this prospective, double blind, randomized control trial. Group Rd received 19ml of 0.5% Ropivaciane with 1mcg/kg  of dexmedetomidine (total 20ml), and Group RD received 19ml of 0.5% Ropivacaine with 2mcg/kg of dexmedetomidine (total 20ml). Onset and duration of sensory and motor block, duration of analgesia, sedation score, hemodyanamic changes were compared. We also monitored for various un towards effects. Results: The onset time of sensory and motor block (9.36±1.114 mins and 14.40 ± 1.528 mins in group Rd vs 8.32 ±0.945 mins and 12.40 ± 1.21 mins in group RD) were not significantly different between two groups (p-value > 0.05).The duration of sensory and motor block (596.20 ± 76.859 mins and 541.20±81.564 mins in group Rd vs 730.80 + 65.187 mins and 659.80±93.607 mins in group RD) were not significantly longer in group RD than group Rd (p-value > 0.05). The duration of analgesia (626.00±70.475 mins in group Rd vs 754.00±60.139 mins in group RD) were not significantly longer in group RD than group Rd (p-value > 0.05). Hemodynamic parameters were also comparable between two groups (p-value >0.05) but 3 patients in RD group (2mcg/kg) developed bradycardia and required treatment with atropine whereas in Rd group (1mcg/kg) none developed bradycardia. Conclusions: There is no significant difference in the onset and duration of block between the two groups. However, higher dose of    dexmedetomidine is associated bradycardia. Hence, in comparision with 2mcg/kg, 1mcg/kg of   dexmedetomidine is better adjuvant to 0.5% ropivaciane in terms of safety and effectiveness.Keywords: dexmedetomidine; ropivacaine; supraclavicular brachial plexus block. 

scholarly journals Comparison between Morphine and Hyaluronidase Added to Local Anesthetic in Sonar Guided Supraclavicular Brachial Plexus Block; Randomized Double Blinded Controlled Study

2021 ◽  
pp. 155-165
Author(s):  
Ahmed A. E. Elmaghraby ◽  
Amany F. Omara ◽  
Rabab M. Mohammed ◽  
Ashraf E. Alzeftawy
Keyword(s):  
Brachial Plexus ◽  
Normal Saline ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Sensory Block ◽  
Control Group ◽  
Morphine Group ◽  
Rescue Analgesia ◽  
Supraclavicular Brachial Plexus Block ◽  
Plexus Block

Background: Huge volumes of local anaesthetics used in conventional blocks may be associated with complications. Hyaluronidase is an enzyme that hydrolyses hyaluronic acid in the tissue. It has been shown to aid the spread of local anaesthetics (LA) through tissue. The aim of this study was to compare between the addition of morphine or hyaluronidase to local anaesthetic in sonar guided supraclavicular brachial plexus block regarding the onset and duration of the block, postoperative analgesia and the total analgesic requirements in the first 24 hours. Patient and methods: Seventy-five patients of American Society of Anaesthesiologists (ASA) physical status I & II, aged 18-60 years, scheduled to acute or elective elbow, forearm or hand surgery under sonar guided supraclavicular brachial plexus block at Tanta University Hospital were randomly allocated into three equal groups; Group I (Control group) received 20 ml containing 9 ml bupivacaine 0.5% and 9 ml lidocaine 2% plus 2 ml normal saline, group II (Morphine group) received 20 ml containing 9 ml bupivacaine 0.5% and 9 ml lidocaine 2% plus 5 mg morphine in 2 ml normal saline and group III (Hyaluronidase group) received 20 ml containing 9 ml bupivacaine 0.5% and 9 ml lidocaine 2% plus 1500 units of hyaluronidase in 2 ml normal saline. The onset of sensory and motor block, duration of sensory and motor block, postoperative VAS, time to first rescue analgesia, total morphine consumption and possible side effects were recorded. Results: Onset of the sensory block and motor block was significantly shorter in the hyaluronidase group than control group and morphine group. Duration of the sensory block and motor block was significantly prolonged in morphine group than hyaluronidase group & control group. VAS started to increase at 6 hours in the control group, at 10 hours in morphine group and at 8 hours in hyaluronidase group. Time to first rescue analgesia was significantly prolonged in morphine group than control group and hyaluronidase group. Total analgesic consumption of morphine was significantly lower in morphine group than control group and hyaluronidase group. Conclusion: Morphine was superior to hyaluronidase as regarding to improving the post-operative pain. The incidence of complications was nil and self-limited in the three groups.

scholarly journals Effect of Dexmedetomidine as an Adjuvant to Bupivacaine in Supraclavicular Brachial Plexus Block

2019 ◽  
Vol 2 (1) ◽  
pp. 48-54
Author(s):  
Sabin Gauchan ◽  
Samyukta Acharya ◽  
Dikshya Karki
Keyword(s):  
Brachial Plexus ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Onset Time ◽  
P Value ◽  
Ultrasound Guided ◽  
Supraclavicular Brachial Plexus Block ◽  
Group B ◽  
Plexus Block ◽  
Group D

Introduction: The objective of this study was to evaluate the effect of 50μg dexmedetomidine on the onset and duration of block and duration of analgesia when used as an adjuvant to bupivacaine in ultrasound guided supraclavicular brachial plexus block. Methods: Eighty patients of ASA physical status I and II undergoing elective upper limb surgery under ultrasound guided supraclavicular brachial plexus block were randomly divided into two groups: Group D and Group B. Group D (n=40) received 19.5 ml of 0.5% bupivacaine with 0.5 ml (50 μg) dexmedetomidine. Group B (n=40) received 19.5 ml of 0.5% bupivacaine with 0.5 ml normal saline. Onset time of sensory and motor block, duration of sensory and motor block and duration of analgesia was recorded. Results: Onset time of sensory block (10.55±4.84 min in Group D vs 12.50 ±5.20 min in Group B) and motor block (15.85±5.9min in Group D vs 18.35±5.6min in Group B) though earlier in Group D as compared to Group B was not statistically significant (p value =.087 for sensory block and p value=.058 for motor block). The duration of sensory block (772.20 ±167.84 min in Group D vs 398.38 ±129.839min in Group B) and motor block (725.63±140.964min in Group D vs 361.88±128.764 min in Group B) was statistically significantly prolonged in Group D (p value= .000 for sensory and p value =.000 for motor block). The Duration of analgesia (845.93±184.545min in Group D vs 430.04±121.307 min in Group B) was also statistically significantly prolonged in group D (p value= .000). Conclusions: Dexmedetomidine (50 μg) as an adjuvant to 0.5% bupivacaine solution in ultrasound guided supraclavicular brachial plexus block prolongs the duration (sensory and motor) of block as well as the duration of analgesia with no effect on the onset time of block. Keywords: brachial plexus block; bupivacaine; dexmedetomidine. Correspondance: Dr.

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