A Comparative Study Of 0.5% Lignocaine Versus 0.5% Lignocaine with Dexmedetomidine for Intravenous Regional Anaesthesia for Upper Limb Surgeries

Abstract

Background: Intravenous Regional Anaesthesia (IVRA), commonly referred to as Bier's block, is a widely used technique for upper limb surgeries. While lignocaine has been the standard local anesthetic for this procedure, recent studies suggest that the addition of adjuncts like dexmedetomidine may enhance the quality of anesthesia and improve postoperative analgesia. This study aims to compare the efficacy and safety of 0.5% lignocaine versus 0.5% lignocaine with dexmedetomidine in patients undergoing upper limb surgeries under IVRA. Objective: To compare the onset, quality of anesthesia, duration of sensory and motor blockade, and postoperative analgesia between two different anesthetic regimens: 0.5% lignocaine and 0.5% lignocaine with dexmedetomidine for intravenous regional anaesthesia in upper limb surgeries. Methods: In this study 60 patients 30 in each group undergoing elective upper limb surgeries were randomly assigned to receive either 0.5% lignocaine (Group L) or 0.5% lignocaine with 0.5 μg/kg dexmedetomidine (Group LD) for IVRA. The onset time, duration of sensory and motor block, quality of anesthesia, and incidence of complications were recorded. Postoperative pain scores, the need for additional analgesia, and adverse events were also evaluated. Results: Patients in the dexmedetomidine group (Group LD) showed a significantly faster onset of anesthesia, longer duration of sensory and motor block, and better postoperative analgesia compared to the lignocaine-only group (Group L). The incidence of complications, including tourniquet pain, were comparable between the two groups, with no significant differences in adverse effects. Conclusion: The addition of dexmedetomidine to 0.5% lignocaine in intravenous regional anaesthesia for upper limb surgeries provides enhanced sensory and motor block characteristics, prolonged postoperative analgesia, and improved patient satisfaction without a significant increase in complications. Dexmedetomidine appears to be a useful adjunct in IVRA for upper limb surgeries, potentially improving the clinical outcomes and the overall quality of anesthesia.