A comparative study of fentanyl versus dexmedetomedine as adjutants to ropivacaine in supraclavicular brachial plexus block in patients undergoing elective upper limb surgery: A Double-blind, Prospective, and Randomized Study

Abstract

Introduction: Brachial plexus block is the most commonly used method of anaesthesia for upper limb surgeries. Various types of local anaesthetics and adjuvants are used to provide block. But there are very few studies comparing fentanyl and dexmedetomedine as adjuvants to ropivacaine in brachial plexus block. So we decided to carry out a comparative evaluation of two drugs for their adjuvant use with ropivacaine in supraclavicular block among patients undergoing upper limb orthopedic surgeries.Settings and design: This was a prospective, randomized, double-blinded study.Methods: The patients were randomly divided into two groups of 40 each using computerized randomization table. Group A (R+F) patients received 30 ml of 0.5% ropivacaine with 1 μg/kg of fentanyl diluted with normal saline (NS) to make a total volume of 35 ml. Group B (R+D) patients received 30 ml of 0.5% ropivacaine with 1 μg/kg of dexmedetomidine diluted with normal saline to make a total volume of 35 ml. Results:Mean motor and sensory block onset time and degree of block was similar in both groups, while mean duration of sensory and motor block and total duration of analgesia was more in Group B(R+D) compared to group A(R+F). Level of sedation in post op was more in group B.Conclusion: The upper limb surgeries performed under the influence of supraclavicular block with .5% ropivacaine and dexmedetomidine 1 g/kg as an adjuvant is highly effective in prolonging the duration of sensory and motor blockade and duration of analgesia with better quality of block as compared to 0.5% ropivacaine with fentanyl (1/kg).