Comparative study of Fentanyl versus Dexmedetomidine with 0.75 percent Ropivacaine in Supraclavicular Block for Upper Limb Surgery

Abstract

Aim: Comparing the potency of fentanyl and dexmedetomidine as adjuvants in the supraclavicular block to 0.75 percent ropivacaine. Materials and Methods: 90 Patients listed for orthopaedic upper limb surgery under ultrasound guided Supraclavicular brachial plexus block were randomly divided into three categories. Group R received 23ml of 0.75% Ropivacaine and 2ml Normal Saline, Group RF was given 0.75% Ropivacaine( 23 mL) with 1mcg/kg of Fentanyl and Group RD received 0. 75% Ropivacaine (23 mL) with 1mcg/kg of Dexmedetomidine. Block characteristics in all three groups were observed.Results: For all three groups demographic profile and hemodynamic parameters was equivalent. The mean time of onset and completion of the sensory and motor block was significantly less in the groups RD and RF relative to the group R and even in the RD group compared with the RF group. The overall sensory block and motor block duration was significantly greater in the groups RD and RF relative to the group R and even in the RD relative to the RF group. The mean time for first rescue analgesia in RD and RF was significantly higher than in R group and even higher in RD compared to RF group. Rescue analgesic requirement in the first 12 hours was more in control group compared to RD and RF group. There were no grievous side- effects seen in any group. Conclusion: Ropivacaine with dexmedetomidine produced a more prolonged duration of motor and sensory block and postoperative analgesia as compared to ropivacaine with fentanyl or ropivacaine alone.