Supraclavicular Brachial Plexus Block: Effect of Using Dexmedetomidine as Adjuvant to Ropivacaine. A Randomized Double Blind Study

Abstract

Background And Aims: Brachial plexus block is the cornerstone of regional anaesthesia practice. Various adjuncts have been used as adjuvants to ropivacaine in the past. This study was done to see the effect on duration of analgesia using dexmedetomidine as adjuvant to ropivacaine 0.5% in supraclavicular brachial plexus block (SBPB). Method: A total of eighty patients undergoing elective upper limb surgeries under SBPB were enrolled for study. The patients were divided into two groups of 40 patients each and given 29 ml ropivacaine 0.5% alone (gp R) or 29 ml ropivacaine 0.5% along with dexmedetomidine 100µg(gp D). Sensory block was assessed by Hollmen scale and motor block by Bromage scale. Onset time of sensory and motor block, total duration of sensory and motor block, duration of analgesia and total analgesic consumption were recorded as primary end point. Patients were monitored for level of sedation, VAS scores and any side effects, intraoperatively and post operatively. Results: Inspite of similar demographic profile, sensory and motor block onset times were shorter in dexmedetomidine group (gp D) than ropivacaine only group (gp R).Total duration of sensory and motor block were significantly longer in gp D as compared to gp R. Total duration of analgesia was longer in gp D where total analgesic consumption was also much less than gp R. Conclusion: Addition of 100µg of dexmedetomidine to 0.5% ropivacaine in SBPB for arm and forearm surgeries shortens the onset of motor and sensory block, prolongs the total duration of block and total duration of a pain free period without significant side effects.