Dexmedetomidine as an adjunct to bupivacaine and xylocaine with adrenaline in ultrasound guided supraclavicular brachial plexus block in upper limb surgeries

Authors

DOI:

https://doi.org/10.3126/jpahs.v9i1.31127

Keywords:

Bupivacaine, Dexmedetomidine, Supraclavicular Block, Ultrasound Guided, Upper Limb Surgery, Xylocaine with Adrenaline

Abstract

Introduction: Supraclavicular brachial plexus block is widely used for perioperative anesthesia and analgesia. Dexmedetomidine is highly selective alpha-2 receptor agonist which provides analgesia, sedation and anxiolysis. Our study aims to evaluate the effect of addtion of dexmedetomidine with bupivacaine and xylocaine with adrenaline in supraclavicular block in upper limb surgeries.

Method: This was a comparative study conducted at Patan Hospital, Patan Academy of Health Sciences, Nepal among 44 patients randomly assigned in Group-I (N=22, bupivacaine and xylocaine with adrenaline 28 ml + dexmedetomidine 2 ml (1 mcg/kg), and Group-II (N=22, without dexmedetomidine) for ultrasound-guided supraclavicular block for upper limb surgeries. The study was approved by institutional review committee. Onset of sensory and motor block, duration of analgesia, demographics, hemodynamic parameters, and side effects of drug were compared.  Pin-prick test and modified Bromage scale were used to evaluate sensory and motor block. Visual analogue scale was used for severity of pain. Statistical analysis was performed with SPSS v.16.

Result: The median time for onsets of sensory and motor block were significantly shorter in group I (1 m and 3 m) than group II (5 m and 10 m). The duration of analgesia was s longer in group I (720 m) than group II (360 m). Two patients had bradycardia and one hypertension in dexmedetomidine group whch were managed successfully.

Conclusion: Dexmedetomidine added to local anesthetics significantly prolongs the effect of supraclavicular block in upper limb surgeries.

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Author Biographies

Alisha Shrestha, Patan Academy of Health Sciences, Lalitpur, Kathmandu, Nepal

Lecturer, Department of Anaesthesia, Patan Hospital

Abhisesh Shrestha, Patan Academy of Health Sciences, Lalitpur, Kathmandu, Nepal

Assistant Professor, Department of Anaesthesia, Patan Hospital

Anil Shrestha, Patan Academy of Health Sciences, Lalitpur, Kathmandu, Nepal

Assistant Professor, Department of Anaesthesia, Patan Hospital

Roshan Piya, Patan Academy of Health Sciences, Lalitpur, Kathmandu, Nepal

Assistant Professor, Department of Anaesthesia, Patan Hospital

Manisha Pradhan, Patan Academy of Health Sciences, Lalitpur, Kathmandu, Nepal

Assistant Professor, Department of Anaesthesia, Patan Hospital

Shirish Prasad Amatya, Patan Academy of Health Sciences, Lalitpur, Kathmandu, Nepal

Assistant Professor, Department of Anaesthesia, Patan Hospital

Niroj Hirachan, Patan Academy of Health Sciences, Lalitpur, Kathmandu, Nepal

Assistant Professor, Department of Anaesthesia, Patan Hospital

Binam Ghimire, Patan Academy of Health Sciences, Lalitpur, Kathmandu, Nepal

Lecturer, Department of Anaesthesia, Patan Hospital

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Published

2022-01-07

How to Cite

Shrestha, A., Shrestha, A., Shrestha, A., Piya, R., Pradhan, M., Amatya, S. P., Hirachan, N., & Ghimire, B. (2022). Dexmedetomidine as an adjunct to bupivacaine and xylocaine with adrenaline in ultrasound guided supraclavicular brachial plexus block in upper limb surgeries. Journal of Patan Academy of Health Sciences, 9(1), 25–31. https://doi.org/10.3126/jpahs.v9i1.31127

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Section

General Section: Original Articles