Comparison of magnesium sulphate and dexmedetomidine as an adjuvant to bupivacaine for supraclavicular brachial plexus block using nerve stimulator a prospective double blind randomised control study

Authors

  • Vinay M S Senior Resident, Department of Anesthesiology, Shimoga Institute of Medical Sciences, Shimoga, Karnataka India
  • Mamtaz A Senior Resident, Department of Anesthesiology, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India
  • Ann Susan Matthew Senior Resident, Department of Anesthesiology, Mysore Medical College and Research Institute, Mysore, Karnataka, India
  • Sreeharsha B Department of Anesthesiology, Mallya Hospital, Bangalore, Karnataka, India

Keywords:

Dexmedetomidine; Magnesium sulphate; Bupivacaine; Supraclavicular Brachial plexus block; Nerve stimulator.

Abstract

Background and Objective: Supraclavicular brachial plexus block is one of the most commonly used regional techniques for most of the upper limb orthopedic surgeries. Various adjuvants have been used to prolong the block duration. Nowadays opioid free anesthesia is being practiced more; non opioid drugs like Dexmedetomidine and Magnesium sulphate both are superior in their action of early onset and prolongation of sensory and motor blockade when added to Las. Material and Methods: We have taken120 ASA I/II patients aged between 20–60 years of both sex, posted for elective upper limb orthopedic surgeries were enrolled in a prospective double blind randomized control study after informed consent. The studies conducted in Krishna Rajendra Hospital attached to Mysore Medical College and Research Institute, Mysore. The 120 patients were randomly allocated in 2 groups and 50 patients received Bupivacaine 0.5% 29.5ml + Dexmedetomidine 50μg. (Group DB) and 50 patients received Bupivacaine 0.5% 29.5ml + Magnesium sulphate 250mg. (Group MB). Under aseptic precautions supraclavicular brachial plexus block was done using perivaascular Nerve stimulator technique using study drugs. The duration onset of sensory and motor blockade, total duration of sensory and motor blockade, haemodynamic status during the peri-operative period and any other side effects were monitored. The technique acceptance by the patient and also the rescue analgesia required are studied during the post-operative period. Results: The onset of sensory and motor blockade was faster in Group DB. The onset time for sensory block was 8.00±0.93 min in Group DB and 12.59±1.15 min in Group MB with statistical significance of P <0.001. The onset time for motor blockade was 11.31±1.40 min Group DB and 17.78±1.27 min in Group MB with statistical significance of P <0.001. Duration of sensory and motor blockade both were significantly prolonged in Group DB. Duration of sensory blockade was 632.72±58.56 min in Group DB and 308.60±26.52 min in Group MB with statistical significance of P < 0.001. Duration of motor blockade was 472.80±26.86 min in Group DB and 274.60±26.93 min in Group MB with statistical significance of P < 0.001. There were no adverse events noted in either group. All patients were haemodynamically stable without requiring any intervention. Conclusion: The addition of Magnesium sulphate and Dexmedetomidine to Bupivacaine for Supraclavicular brachial plexus block produces significant early onset of sensory and motor blockade also prolonged the total duration of sensory and motor blockade without much side effects. In comparison to Magnesium sulphate addition of Dexmedetomidine has more prolongation of sensory and motor blockade, requiring less sedative drugs and better patient acceptance during post-operative period as an advantage.

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Published

2021-09-30

How to Cite

Vinay M S, Mamtaz A, Ann Susan Matthew, & Sreeharsha B. (2021). Comparison of magnesium sulphate and dexmedetomidine as an adjuvant to bupivacaine for supraclavicular brachial plexus block using nerve stimulator a prospective double blind randomised control study. International Journal of Health and Clinical Research, 4(17), 272–280. Retrieved from https://ijhcr.com/index.php/ijhcr/article/view/2826