To compare the efficacy of fentanyl versus dexmedetomidine as adjuvant to 0.5% bupivacaine in ultrasound guided supraclavicular brachial plexus block in upper limb surgeries

Abstract

Aims: The study was undertaken to compare between Dexmedetomidine and Fentanyl as adjuvants to 0.5% Bupivacaine hydrochloride in Ultrasound guided Supraclavicular Brachial Plexus block. Materials and methods: This clinical study was conducted in 60 patients of both sex, of age group 18-50 years admitted to Gandhi Hospital for upper limb surgeries from 2016-2017. They were randomly divided into two groups of 30 patients each –Group F (Fentanyl) – was given conventional supraclavicular brachial plexus block with 30 ml of 0.5% Bupivacaine and 1 μg/kg of Fentanyl. Group D (Dexmedetomidine) – was given conventional supraclavicular brachial plexus block with 30ml of 0.5% Bupivacaine and 1 μg/kg of Dexmedetomidine. Results: The average age was 33.13 ± 9.179 years in group F, and 31.4 ± 8.295 years in group D. The average weights of the patients were 67.66 ± 8.38 kgs in group F and 69 ± 9.505 kgs in group D respectively. There was no significant difference in age and weight between the two groups. The mean time of onset of sensory blockade in group F was 6.83 ± 1.72min. In group D it was 7.03 ± 1.43 min. The slight delayed onset of sensory blockade in group D is however not statistically significant (p value >0.05). The mean time of onset of motor blockade was 11.13 ± 2.25 in group F when compared to 11.23 ± 2.23 in group D. This was not clinically or statistically significant (p value >0.05). The mean time for duration of analgesia was 357 ± 37.62 min in group F whereas in group D the mean was 489.66 ± 59.91 min. This was statistically significant with a p value of <0.0001. Conclusion: Dexmedetomidine (1 μ g/kg ) seems to be an attractive alternative to Fentanyl (1 μ g/kg) as an adjuvant to bupivacaine in supraclavicular brachial plexus block. It provides good quality of intraoperative analgesia, hemodynamically stable conditions, minimal side effects, and excellent quality of postoperative analgesia.