COMPARISON OF DEXMEDETOMIDINE AND DEXAMETHASONE USED AS AN ADJUVANT TO ROPIVACAINE IN ULTRASOUND-GUIDED SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK
Main Article Content
Keywords
Brachial plexus block, Dexmedetomidine, Dexamethasone, Ropivacaine, VAS score
Abstract
Background: Supraclavicular brachial plexus (SCBP) block is one of the most preferred techniques to provide anaesthesia for upper limb surgeries. Various adjuvants have been used to extend the duration of the block. We compared dexmedetomidine and dexamethasone as an adjuvant to 0.5% Ropivacaine in extending the duration of supraclavicular brachial plexus block and postoperative analgesia.
Aim: This study aims to compare dexmedetomidine and dexamethasone as an adjuvant to 0.5% Ropivacaine in extending the duration of supraclavicular brachial plexus block and postoperative analgesia.
Methods: In this study 60 ASA Physical Status Ⅰ/Ⅱ patients undergoing elective upper limb surgeries under ultrasound guided supraclavicular brachial plexus block were randomized into two groups. Group 1(n=30) received 30ml of 0.5% ropivacaine containing 1mcg/kg dexmedetomidine. Group 2(n=30) received 30ml of 0.5% ropivacaine containing 8mg dexamethasone. Parameters studied were onset and duration of sensory and motor block, duration of analgesia and side effects.
Results: We noted significant extended duration of motor block and duration of analgesia in Group 1 when compared to Group 2. No adverse effects were noted in both the groups.
Conclusion: Dexmedetomidine when added as an adjuvant to ropivacaine for SCBP block prolongs duration of block and quality of postoperative analgesia as compared to dexamethasone without any significant side effects.
References
[2] Kulenkampff D .Brachial plexus anaesthesia: its indications,technique and dangers.Ann Surg 1928;87(6):883-891.
[3] Kooloth RA, Patel SN, Mehta MK. A comparison of 0.5% Ropivacaine and 0.5% Bupivacaine in supraclavicular brachial plexux block. National Journal of Medical Research 2015;5(1):67-70.
[4] Kuthiala G, Chaudhary G. Ropivacaine: a review of its pharmacology and clinicl use. Indian J Anaesth 2011;55(2):104-110.
[5] Abdallah FW, Brull R. Facilitatory effects of perineural dexmedetomidine on neuraxial and peripheral nerve block: a systematic review and meta-analysis. Br J Anaesth 2013;110(6):915-925.
[6] Azzazi E, Mohamed H, El Sayed El Agamy A, et al. Effect of adding dexamethasone to bupivacaine in ultrasound guided supraclavicular brachial plexus block versus bupivacaine alone for upper limb orthopedic surgery; a comparative study. Egyptian Journal of Hospital Medicine 2018;71(7):3541-9.
[7] Biradar PA, Kaimar P, Gopalakrishna K. Effect of dexamethasone added to lidocaine in supraclavicular brachial plexux block: a prospective, randomised, double-blind study. Indian J Anaesth 2013;57(2):180-184.
[8] Manzoor S, Ara M. Comparison of dexmedetomidine and dexamethasone used as adjuvant to ropivacaine in ultrasound-guided supraclavicular brachial plexus block: an observational study. Anaesthesia Acad Anesthesiol Int 2022;7(1):57-60.
[9] Chinnappa J, Shivanna S, Pujari VS, et al. Efficacy of dexmedetomidine with ropivacaine in supraclavicular brachial plexus block for upper limb surgeries. J Anaesthesiol Clin Pharmacol 2017;33:81.
[10] Waindeskar V, Bhatia K, Garg S, et al. Dexmedetomidine as an adjuvant to levobupivacaine in ultrasound guided supraclavicular brachial plexus block. Int J Med and Dent Sci 2016;5:1184-91.
[11] Ammar AS, Mahmoud KM. Ultrasound guided single injection infraclavicular brachial plexus block using bupivacaine alone or combined with dexmedetomidine for pain control in upper limb surgery: a prospective randomized controlled trial. Saudi J Anaesth 2012;6:109-14.
[12] Agarwal S, Aggarwal R, Gupta P. Dexmedetomidine prolongs the effect of bupivacaine in supraclavicular brachial plexus block. J Anaesthesiol Clin Pharmacol 2014;30:36-40.
[13] Kalpana K, Rao NS, Gopal S. Effect of addition of dexamethasone to ropivacaine in supraclavicular brachial plexus block: a prospective, randomized, double blind study. J Evid Based Med Healthc 2015;2:5016-22.
[14] Dar FA, Najar MR, Jan N. Effect of addition of dexamethasone to ropivacaine in supraclavicular brachial plexus block. Indian J Pain 2013;27:165-9.
[15] Pani N, Routray SS, Mishra D, et al. A clinical comparison between 0.5% levobupivacaine and 0.5% levobupivacaine with dexamethasone 8 mg combination in brachial plexus block by the supraclavicular approach. Indian J Anaesth 2017;61:302-7.
[16] Albrecht E, Vorobeichik L, Jacot-Guillarmod A, et al. Dexamethasone is superior to dexmedetomidine as a perineural adjunct for supraclavicular brachial plexus block: Systematic review and indirect meta-analysis. Anesth Analg 2019;128:543-54.
[17] Verma NK, Ranjan A. A clinical comparison of dexmedetomidine and dexamethasone as adjuvant to ropivacaine in supraclavicular brachial plexus blocks for upper arm surgeries. Int J Adv Res Biol Sci 2016;3:56-61.
[18] Chaithanya K, Reddy N. A comparative study between 0.375% ropivacaine with 50 mcg of dexmedetomidine and 0.375% ropivacaine with 8 mg of dexamethasone for ultrasound guided supraclavicular brachial plexus block. Indian J Clin Anaesth 2017;4:69-73.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr. Shivakumar G.
Professor & HOD, Department of Anaesthesiology, MIMS, Mandya, Karnataka, India.
Dr. Umesh N. P
Associate Professor, Department of Anaesthesiology, MIMS, Mandya, Karnataka, India.
Dr. Arunkumaran D
Third Year Postgraduate student, Department of Anaesthesiology, MIMS, Mandya, Karnataka, India.
Dr. Manoj kumar K.V.
Second Year Postgraduate student, Department of Anaesthesiology, MIMS, Mandya, Karnataka, India.