Comparative study of bupivacaine plus (lignocaine + adrenaline) with dexmedetomidine as an adjuvant versus bupivacaine plus (lignocaine + adrenaline) alone in ultrasound-guided supraclavicular brachial plexus block

Abstract

Introduction: Local anesthetics when used alone for supraclavicular brachial plexus block provide good operative conditions, but have shorter duration of postoperative analgesia. Hence, various adjuvants such as opioids, clonidine, dexamethasone, midazolam, and fentanyl are added to local anesthetics in supraclavicular brachial plexus block to achieve quick, dense, and prolonged block.Aims: To compare the effects of Bupivacaine and Lignocaine + Adrenaline and Bupivacaine and Lignocaine + Adrenaline with Dexmedetomidine combination in ultrasound guided Supraclavicular brachial plexus block.Objectives: To compare the effect of.? Hemodynamic parameters.? Onset of sensory and motor blockade.? Duration of sensory and motor blockade.? To compare post-operative pain levels.? Complication / Side effects if any.Methodology: This prospective, randomized, double-blind trial consists of total 60 patients undergoing elective upper limb procedures, divided into two groups, 30 in each. Group-A Patients received 15 ml of 0.5% Bupivacaine + 15 ml of 1% Lignocaine.+ Adrenaline and Group B Patients received 15ml of 0.5% Bupivacaine + 15 ml of 1% Lignocaine + Adrenaline + Dexmedetomidine 0.75 μg/kg. The parameters recorded were onset and duration of sensory and motor block, DOA, Hemodynamic parameters, and side effects.Results: In both the groups, demographic data were similar. Sensory and motor block onset was significantly shorter (p< 0.05) in Group B than Group A, while the duration of blocks and DOA was prolonged in Group B (p< 0.05). Intraoperative hemodynamics were in optimal range in both Groups.Conclusion: Dexmedetomidine as an adjuvant to local anesthetic in USG supraclavicular plexus block shortens the onset and prolongs the duration of sensory and motor block and DOA.