Key result
Dexmedetomidine (1µg/kg) added to 0.5% ropivacaine significantly reduced the onset time of sensory block (7.40 vs 14.33 minutes, p<0.001) and prolonged its duration compared to ropivacaine alone.
Why the study?
Dexmedetomidine has been shown to be safe and effective in regional anesthesia, but its efficacy when added to 0.5% ropivacaine in supraclavicular brachial plexus block required evaluation.
Does adding dexmedetomidine to ropivacaine improve the onset and duration of sensory and motor blockade in patients undergoing elective upper limb surgery?
RCT (n=60)
computer-generated random number table
No
Does adding dexmedetomidine to ropivacaine improve the onset and duration of sensory and motor blockade in patients undergoing elective upper limb surgery?
Absolute Event Rate: 7.4% vs 14.33%
p-value: p=< 0.001
Adding dexmedetomidine to ropivacaine for supraclavicular brachial plexus block accelerates onset, prolongs block duration, and provides excellent sedation without significant respiratory depression.
Supports dexmedetomidine as ropivacaine adjunct for supraclavicular blocks in upper limb surgery; extends RCT evidence on alpha-2 agonists in regional anesthesia.
Introduction - Dexmedetomidine has been demonstrated to be safe and effective in various neuraxial and regional anesthetic procedures in humans, with fewer adverse effects in several studies.Methodology - This study aimed to study and compare the efficacy of Dexmedetomidine 1μg/kg plus 0.5% Ropivacaine versus 0.5% Ropivacaine alone in brachial plexus block by supraclavicular approach. After obtaining institutional ethics committee approval this prospective, randomized, comparative study was conducted on 60 patients, 18-60 years, either sex scheduled for elective upper limb surgery under supraclavicular brachial plexus block. The primary objective was to study the effects of 0.5% Ropivacaine with Dexmedetomidine 1μg/kg in brachial plexus block in the form of onset and duration of sensory and motor blockade. Secondary objectives included grading the quality of motor block, Sedation Score, Duration of analgesia, Hemodynamic changes, and Side effects, if any.Observations - Group D showed a faster onset and a longer duration of sensory and motor blockage. Rescue analgesia was given with Injection Diclofenac Sodium 75 mg intravenous when patient Numeric Rating Score> 4. The mean sedation score was comparable at baseline, 5th and 10th minutes (P>0.05), significantly higher in Group D from 15th to 480th minutes (P<0.05), and subsequently comparable from 600th to 1440th minutes (P>0.05).Conclusion - When given as an adjuvant to Ropivacaine 0.5% in supraclavicular brachial plexus block, Dexmedetomidine significantly reduces the onset time and increases the duration of sensory and motor block. It also provides excellent sedation during surgery, improves the quality of block, extends the duration of analgesia, and does not cause significant respiratory depression
No takes yet. Share an insight, caveat, or question.
Agarwal et al. (2024) conducted an RCT in Elective upper limb surgery (n=60). Dexmedetomidine plus 0.5% Ropivacaine vs. 30 ml of 0.5% Ropivacaine with 1 ml 0.9% Normal saline was evaluated on Onset time of sensory block (minutes) (p=< 0.001). Dexmedetomidine (1µg/kg) added to 0.5% ropivacaine significantly reduced the onset time of sensory block (7.40 vs 14.33 minutes, p<0.001) and prolonged its duration compared to ropivacaine alone.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: