Abstract

DEXMEDETOMIDINE – A NOVEL DRUG, AS AN ADJUVANT TO LIGNOCAINE AND BUPIVACAINE FOR PROLONGED POST – OPERATIVE ANALGESIA IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK

Dr. Pratiksha Agrawal*, Dr. Swati Bhatt and Dr. Upadhyay

ABSTRACT

Context and aims: Dexmedetomidine is α2 agonist with analgesic, sympatholytic and sedative properties and hence, useful adjuvant in regional anesthesia. We aimed primarily to evaluate the effects of Dexmedetomidine when added in supraclavicular block. Methods and Material: It was a prospective, randomized, double blind, placebo controlled study. Sixty patients of ASA grades I and II undergoing forearm surgeries were randomly allocated into two groups of 30 patients each. Control group C patients received Inj. Bupivacaine (0.5%) 2mg/kg + Inj. Lignocaine (2%) 5mg/kg + Inj. sterile water. Study group D patients received local anesthetics in similar doses + Inj. Dexmedetomidine (1 μgm/kg) + Inj. sterile water. Total volume was 35ml. Parameters noted were onset, peak and duration of sensory and motor block, VAS (Visual analogue scale) score, duration of analgesia, number of rescue analgesics required in first 24 hours post – operatively, Ramsay sedation score, vital parameters and complications, if any. Results were analyzed using MedCalc software. Results: Demographic data and surgical characteristics were comparable in both the groups. Onset times for sensory and motor blocks were significantly shorter, (p< 0.001) while the duration of blocks and duration of analgesia were significantly longer (p < 0.001) in group D. Patients in both the groups maintained stable vital parameters with Ramsay sedation score 2/3. Bradycardia was observed in two patients in the group D. Conclusions: Dexmedetomidine can be used as a safe and effective adjuvant to local anesthetics in supraclavicular block to provide excellent peri-operative analgesia with minimal side effects.

Keywords: Dexmedetomidine, adjuvant, Supraclavicular brachial plexus block, post-operative analgesia.