Key result
Dexmedetomidine as an adjunct to ropivacaine decreased the mean onset of motor block (14.7 vs 18.2 min) and increased the duration of analgesia compared to dexamethasone in upper arm surgeries.
Why the study?
The study was conducted to compare the efficacy of dexamethasone and dexmedetomidine as adjuncts to ropivacaine in brachial plexus blockade as sole anaesthesia for upper arm surgeries.
Does dexmedetomidine compared to dexamethasone as an adjunct to ropivacaine improve the onset and duration of sensory and motor blockade in adult patients undergoing upper arm surgeries?
Observational
Does dexmedetomidine compared to dexamethasone as an adjunct to ropivacaine improve the onset and duration of sensory and motor blockade in adult patients undergoing upper arm surgeries?
Absolute Event Rate: 14.7% vs 18.2%
Dexmedetomidine is a superior adjunct to ropivacaine compared to dexamethasone for decreasing the onset of motor block and enhancing the duration of analgesia in supraclavicular brachial plexus blocks.
BACKGROUND Blockade of brachial plexus at several locations from the roots to the terminal branches will allow for surgical anaesthesia of the upper extremity and shoulder. We have attempted to compare the efficacy of dexamethasone and dexmedetomidine when used as an adjunct to brachial plexus blockade when used as a sole anaesthetic for upper arm surgeries. METHODS After obtaining ethical committee clearance, a prospective observational study was conducted in patients undergoing upper arm surgeries. Patients were compared in two groups; Group 1 received 18 mL Ropivacaine (0.5 %) and Dexamethasone 8 mg (2 mL); Group 2 received Ropivacaine (0.5 %) and 75 mcg Dexmedetomidine along with 1.25 mL isotonic sodium chloride. RESULTS Mean time of onset of sensory blockade was 12.1 ± 1.1 min in Group 1 and 10.3 ± 1.2 min in Group 2. Mean Duration of Analgesia in Group 1 was 1024.5 ± 62.0 min and in Group 2 was 1394.3 ± 189.6 min. Mean Onset of Motor block in Group 1 was 18.2 ± 1.5 min and in Group 2 was 14.7 ± 1.0 min. Mean Duration of motor block in Group 1 was 697.2 ± 37.3 min and in Group 2 was 776.3 ± 48.0 min. CONCLUSIONS Our study revealed that dexmedetomidine is a better alternative for decreasing the onset of motor block along with enhanced quality and duration of supraclavicular block.
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Viswambharan et al. (2020) conducted an observational in Upper arm surgeries. Ropivacaine with Dexmedetomidine vs. Ropivacaine with Dexamethasone was evaluated on Onset of motor block (minutes). Dexmedetomidine as an adjunct to ropivacaine decreased the mean onset of motor block (14.7 vs 18.2 min) and increased the duration of analgesia compared to dexamethasone in upper arm surgeries.
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