Comparative Study of Dexmedetomidine versus Dexamethasone as an adjuvant for supraclavicular brachial plexus block.

Ankit Singh; Neelesh Nema

Volume : VIII, Issue : V, May - 2019

Comparative Study of Dexmedetomidine versus Dexamethasone as an adjuvant for supraclavicular brachial plexus block.

Ankit Singh, Neelesh Nema

Abstract :

Introduction: Brachial plexus block is the most preferred anaesthetic technique for upper limb surgeries. Adding adjuvant to local anaesthetics for achial plexus block may enhance the duration and quality of analgesia and also to decrease the dose of postoperative opioid analgesic. Aims and Objectives: The purpose of this study was to evaluate the effect of dexamethasone or dexmedetomidine when added as adjuvant during supraclavicular achial plexus blocks (BPB) in respect to the onset and duration of sensory and motor block along with duration of analgesia. Methods: Sixty ASA physical status I-II patients of age group between 20 to 60 years with elective forearm and hand surgery under achial plexus blocks were randomly allocated into two equal groups in a randomised double blind fashion. Group DM (n = 30), to receive 15 ml of 0.5% bupivacaine and 15 ml of 2% lignocaine with Adr + 1 ml of Dexmedetomidine (50mcg) + 1ml distilled water, making a total of 32 ml and another Group DX (n = 25), to receive 15 ml of 0.5% bupivacaine and 15 ml of 2% lignocaine with Adr. + 2ml of Dexamethasone (8 mg). A nerve stimulation technique was used in all patients. The onset time and duration of sensory and motor blocks, quality of intraoperative analgesia and duration of analgesia were assessed. Results: The time of onset of sensory and motor block was significantly less in group DM as compared to group DX (P ＜ 0.05). The duration of the sensory and motor block as well as duration of post operative analgesia was significantly more in group DM as compared with group DX (P＜0.05), but there was no statistically significant difference between both the groups with respect to the heart rate, mean arterial pressure and spo2. Conclusions: Dexmedetomidine 50 g was more effective than dexamethasone 8 mg in extending the duration of supraclavicular achial plexus block and prolonging the duration of post operative analgesia and it also significantly decreases the onset time of block.