Key result
Addition of dexmedetomidine to ropivacaine for supraclavicular brachial plexus block significantly prolonged the duration of sensory block (724.18 vs 582.16 min) and motor block.
Why the study?
Adjuvants are used with local anaesthetics to enhance block quality, improve postoperative pain management, and reduce local anaesthetic doses, prompting evaluation of dexmedetomidine with ropivacaine in supraclavicular brachial plexus block.
Does dexmedetomidine added to ropivacaine improve block characteristics and prolong analgesia in patients undergoing elective lower arm surgeries?
RCT (n=60)
randomised
Does dexmedetomidine added to ropivacaine improve block characteristics and prolong analgesia in patients undergoing elective lower arm surgeries?
Absolute Event Rate: 724.18% vs 582.16%
Addition of dexmedetomidine to ropivacaine in supraclavicular brachial plexus block significantly prolongs the duration of sensory and motor block and postoperative analgesia.
Supports dexmedetomidine adjunct for extended analgesia in upper-limb surgery; extends RCT evidence for its use in brachial plexus blocks.
BACKGROUND To improve the quality of block (sensory and motor characteristics), postoperative pain management and reduce large doses of local anaesthetics, various adjuvants are used with local anaesthetic agents. We have evaluated dexmedetomidine as an adjuvant to 0.5 % ropivacaine in supraclavicular brachial plexus block in terms of onset and duration of sensory and motor block & duration of postoperative analgesia. METHODS This is a prospective randomised comparative study. 60 patients who were admitted for elective surgeries of the lower arm, at the level of elbow, forearm & hand were enrolled. They were divided in to two groups of 30 patients each as follows - group RD: supraclavicular brachial plexus block given with 30 mL of 0.5 % ropivacaine + 1 mL (100 μg) of dexmedetomidine. Group RC: supraclavicular brachial plexus block given with 30 mL of 0.5 % ropivacaine + 1 mL of normal saline. Various parameters like onset times and durations of sensory and motor block, duration of analgesia, total analgesic needed, and side-effects were recorded for each patient. RESULTS The time of onset of sensory and motor block was significantly early in dexmedetomidine group than in control group. The duration of sensory and motor block was significantly prolonged in group RD as compared to group RC. The duration of sensory block was 724.18 + 73.26 min in group RD (GD) and 582.16 + 93.12 min. in group RC (GC). The duration of analgesia was significantly prolonged in group RD. CONCLUSIONS Addition of dexmedetomidine as an adjuvant to ropivacaine is associated with early onset of sensory and motor block. The duration of sensory and motor block was prolonged. The duration of analgesia was prolonged and patients required less rescue analgesia. The use of dexmedetomidine was associated with reversible bradycardia and sedation score was less KEYWORDS Ropivacaine, Dexmedetomidine, Adjuvant, Supraclavicular Brachial Plexus Block
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L.R.N.N. et al. (2021) conducted an RCT in Elective surgeries of the lower arm, elbow, forearm, and hand (n=60). Dexmedetomidine vs. 1 mL normal saline added to 30 mL of 0.5% ropivacaine was evaluated on Duration of sensory block. Addition of dexmedetomidine to ropivacaine for supraclavicular brachial plexus block significantly prolonged the duration of sensory block (724.18 vs 582.16 min) and motor block.
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