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Indian Journal of Anesthesia and Analgesia

Volume  10, Issue 3, July-September 2023, Pages 85-95
 

Original Article

Study of Dexmedetomidine as an Adjuvant to Bupivacaine- Lignocaine with Adrenaline in Supraclavicular Brachial Plexusblock

Sandhya Gujar 1, Karuna Sidam 2

1 Professor, 2 Specialist Anaesthesia, Department of Anesthesiology, ESI-Post Graduate Institute of Medical Science & Research, Andheri 400093, Mumbai, Maharashtra, India.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.10323.1

Abstract

Supraclavicular brachial plexus block is a very popular mode of anesthesia for various upper limb surgeries, as it is easiest and most effective and has good post-operative analgesia. It is carried out at the level of trunks i.e7 at the middle of brachial plexus, resulting in homogenou spread of anesthetic agent throughout the plexus with a fast onset and complete block action.9 Dexmedetomidine, is potent, highly selective α2-adrenoceptor agonist, has been used as an adjuvant during regional and local anesthesia because of rapid onset of action and relatively short half-life up to 2 hours.

Objective of Study: To compare the effects of addition of Dexmedetomidine to Bupivacaine- Lignocaine with Adrenaline combination for Supraclavicular brachial plexus block with regards to onset and duration of sensory block, motor block. Quality of anesthesia, analgesia and Adverse reactions if any after taking written informed consent.

Observations: Onset of sensory as well as motor blockade in Dexmedetomidine group was earlier when compared to plain bupivacaine-lignocaine adrenalin group. The duration of sensory and motor blockade was significantly increased (p<0.05) in Dexmedetomidine group when compared to another group. With respect to hemodynamic parameters Dexmedetomidine group provided a higher Degree of cardiovascular stability with a lesser incidence of hypotension.

Result: There is earlier onset of action and longer duration of sensory; Motor block and Duration of analgesia (sensory block) was prolonged in dexmedetomidine group. Hence it is advisable to add dexmedetomidine as an adjuvant to local anesthetic combinations during supraclavicular block for prolonged anesthesia and to provide better analgesia


Keywords : 0.5% Bupivacaine; 2% lignocaine with adrenaline; Dexmedetomidine; Peripheral nerve stimulator (stimuplex DIG RC); Sensory and motor blockade.
Corresponding Author : Sandhya Gujar