KUMJ | VOL. 19 | NO. 3 | ISSUE 75 | JULY - SEPT. 2021
Supraclavicular Brachial Plexus Block: Comparison of Varying Doses of Dexmedetomidine with Ropivacaine
Shakya S, Singh J, Ghimire A, Shrestha B
Abstract: Background
Alpha-2 adrenergic receptor agonists have been the focus of interest nowadays as an
adjuvant to local anesthesia due to its excellent sedative, analgesic, antihypertensive,
anesthetic sparing and hemodynamic stabilizing properties. The ideal dose of
dexmedetomidine for brachial plexus block is matter of debate.
Objective
To find the appropriate minimal dose of dexmedetomidine with desired clinical
effects and minimal side-effects, we compared different doses (25 mcg, 50 mcg, 75
mcg and 100 mcg) of dexmedetomidine as an adjuvant to ropivacaine.
Method
One hundred fifty patients of ASA I and II, aged (18-60) years, weighing (50-60)
kilograms undergoing upper limb surgeries under brachial plexus block were enrolled
in this prospective, double blind, randomized control study. Patients in all group
received 19 ml of 0.5% ropivacaine in common. In addition; group RD25, RD50, RD75
and RD100 received 25 mcg, 50 mcg, 75 mcg and 100 mcg of dexmedetomidine
diluted in 1 ml of normal saline (NS) respectively whereas group RD00 received
only 1 ml of NS. The duration of analgesia was the primary outcome whereas block
characteristics, hemodynamic parameters, oxygen saturation, sedation score and
adverse effects were taken as secondary outcome. Statistical analysis was done using
ANOVA test, Chi-square test and Scheffe’s multiple comparison tests.
Result
The demographic profile and baseline hemodynamic variables were comparable in
all five groups. Increasing dose of dexmedetomidine showed significant improvement
in block characteristics but associated with increase in sedation and incidence of
bradycardia.
Conclusion
We conclude that dexmedetomidine 50 mcg would be an appropriate dose as
adjuvant to local anesthesia in brachial plexus block.
Keyword : Analgesia, Brachial plexus block, Bradycardia, Dexmedetomidine, Ropivacaine
