Comparative Study of Ropivacaine 0.75% Alone and Ropivacaine 0.75% with Dexmedetomidine 50 μg as Adjunct in Supraclavicular Brachial Plexus Block Using Peripheral Nerve Stimulator

Abstract

Introduction: Supraclavicular brachial plexus block is preferred for its rapid onset, reliable anesthesia and as a safe technique for any surgery in the upper extremity that does not involve the shoulder. Aim: The aim of the present study is to compare haemodynamic, sensory and motor effects of Ropivacaine alone and Ropivacaine along with Dexmedetomidine in Supraclavicular Brachial Block in upper limb surgery. Methods and materials: The present study was carried out on patients undergoing elective upper limb surgery during the period from January- 2018 to August-2019. The study included total 60 patients belonging to ASA grade I and II of either sex with age between 18-60 years posted for various elective upper limb surgery.Results: There was no significant difference in the study groups with regards to demographic profile and duration of surgery. The onset of sensory and motor blockade was faster in group-RD than group-R. Onset of sensory block: (group-R=14.133± 1.676 min & group-RD=12.667± 1.213min) (p=0.000), Onset of motor block :( group-R=25.967± 2.748min & group-RD=23.333± 3.467min) (p=0.002). Also total duration of sensory blockade {Group R=547.833± 26.152mins, Group RD =811.667± 25.405 mins (p value = 0.000)}, motor blockade {Group R=509.667± 24.703mins, Group RD = 760.667± 28.062mins (p value = 0.000)} and number of rescue injections in 24 hours {Group R=2.733± 0.450, Group RD=1.400± 0.498 (p value = 0.000)} was significantly different in two groups. There was good haemodynamic stability in both groups. There was no incidence of any side effects in both groups.Conclusion: Dexmedetomidine in a dose of 50μg added to ropivacaine in supraclavicular brachial block for upper limb surgery significantly shortens the onset time and prolongs the duration of sensory and motor blocks without producing sedation in patients. Total number of rescue analgesics required in postoperative period is also less with use of Dexmedetomidine as an adjuvant to Ropivacaine.