A prospective randomized control study comparing efficacy of dexmedetomidine versus dexamethasone as adjuvant to 0.2% ropivacaine in interscalene block as post-operative analgesia for shoulder arthroscopic surgeries

Abstract

Background: Arthroscopic shoulder surgeries can be done under general anesthesia, regional anesthesia or combination of both. In patients undergoing shoulder surgeries, pain may persist in postoperative period despite multimodal analgesia. Interscalene block is most widely used regional anesthetic technique for arthroscopic shoulder surgeries and provide adequate effective analgesia in postoperative period thus initiating rehabilitation, decreasing hospital stay.Results: In this study, we found that Post-Operative VAS score was comparable between the group A and B till 6hours of follow up. Afterwards mean VAS Score 12hours (0.0 vs 0.63) (p<0.01) 18 hours (0.33 vs 1.80) (p<0.01) and 24 hours (1.17 vs 3.10) (p<0.01) mean VAS score was significantly lower in dexmedetomidine group as compared to dexamethasone group till 24 hours post-op period. Mean duration of sensory (12.12 vs 10.12 hours; p<0.01) and motor block (11.32 vs 9.15; p<0.01) was significantly prolonged with dexmedetomidine than dexamethasone. Time for first rescue analgesia was prolonged in dexmedetomidine group as compared to dexamethasone (13.23 vs 10.87 hours; p<0.01)Conclusion: We conclude that Dexmedetomidine when added to 0.2% Ropivacaine in interscalene brachial plexus block as postoperative analgesia, have better effects in terms of prolonged duration of sensory, motor block, post-operative analgesia, with less requirement for rescue analgesics, stable hemodynamics and minimal side effects. Hence dexmedetomidine is better adjuvant than dexamethasone with ropivacaine.