Abstract
Background: Peripheral nerve block has gained increased popularity due to less postoperative pain, reduced need for postoperative analgesic drugs, reduction of PACU time, and improved patient satisfaction. The aim of the study was to compare the effect of ketamine and dexmedetomidine as additives to bupivacaine on onset and duration of the block, post-operative VAS, and analgesic consumption, after ultrasound-guided supraclavicular nerve block. Methods: 75 adult patients undergoing elective operations of the elbow, forearm, wrist, or hand were randomly allocated into three groups of 25 patients each. Group K (ketamine group) received 40 ml 0.25% bupivacaine contain 1 mg/kg ketamine, Group D (dexmedetomidine group) received 40 ml 0.25% bupivacaine contain 1ug/kg dexmedetomidine, group C (control group) received 40 ml 0.25% bupivacaine. The outcome measures included visual analog scale (VAS, 0 = no pain 10 cm = the most severe pain), time to first analgesic request, and total dose of diclofenac analgesia given postoperatively. Sedation score also recorded in all groups Results: Patients in D and K groups had reduced VAS scores than the C group, at all-time points after surgery during the first 24 hours, with more reduction in D than K group ( P < 0.05). The time of the first analgesic request in the D group was significantly more than in the K group and both were more than the C group (9.48±1.417 h, 7.08 ±1.255 h, and 5.00 ± 1.04 h respectively). Conclusions: The addition of ketamine or dexmedetomidine in the ultrasound-guided supraclavicular brachial plexus block could improve the postoperative pain and need for analgesia. Therefore, we can consider the low price more available ketamine as a comparable adjuvant in brachial plexus block to some extent as dexmedetomidine. Trial registration: https://www.clinicaltrials.gov/ct2/show/NCT04508894, Date of registration (02/21/2019).
Buprenorphine as an adjuvant to 0.5% ropivacaine for ultrasound-guided supraclavicular brachial plexus block: A randomized, double-blind, prospective study
