Assessment of Duration of Analgesia in Ultrasound guided 4-in-1 Nerve Block with Bupivacaine in Combination with Dexmedetomidine in Two Doses for Knee and Below Knee Orthopaedic Surgeries

Background: The purpose of the current study was to evaluate the duration of analgesia following knee and below-knee orthopaedic surgery using an ultrasound-guided 4-in-1 nerve block with Bupivacaine combined with Dexmedetomidine in two doses. Material and Methods: A comparative study was carried out among patients planned to undergo knee and below knee surgeries under SAB. A total of 100 patients were randomly divided into 2 groups. Group A was given 29ml of 0.125% bupivacaine with 0.5µg/kg dose of dexmedetomidine (1ml) making it to a total 30ml solution, in USG guided 4 in 1 block while Group B was given 29 ml of 0.125% bupivacaine with 1µg/kg dose of dexmedetomidine (1ml) making it to a total 30 ml solution, in USG guided 4 in 1 block. In the study, Duration of analgesia or Total pain free period was defined as the time interval between the pain free periods after administration of the spinal block to the first rescue analgesic administration. Results: In this study, mean age of the participant was 40.64±11.44 years in Group A and 40.12±12.55 years in Group B ranging from 18 years to 60 years. Maximum participant in Group A (n = 18) aged between 41 and 50 years and in Group B (n = 17) were aged between 30 and 40 years. Only 10 participants aged below 30 in both the groups. The study population comprised of 36 males in Group A and 31 males in Group B and 14 females in Group A and 19 females in Group B. There was no significant difference of gender between both groups (p = 0.287). Duration of post-operative analgesia in group A and group B was 666.48±82.45 min and 801.96±92.97 min respectively. In this study, duration of total pain free period was significantly longer in group B in comparison to group A (p = 0.0001). Conclusion: The study concluded that duration of total pain free period was significantly longer in group B in comparison to group A.