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September 1, 2023Journal of Medical SocietyOpen Access

“Comparison of fentanyl and dexmedetomidine as an adjuvant to bupivacaine in supraclavicular brachial plexus block:” A randomized double-blind prospective study

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Why the study?

The study was conducted to compare the efficacy of fentanyl versus dexmedetomidine as an adjuvant to bupivacaine for supraclavicular brachial plexus block in upper extremity surgeries.

Does dexmedetomidine compared to fentanyl as an adjuvant to bupivacaine improve the onset and duration of supraclavicular brachial plexus block in patients undergoing upper limb surgeries?

Comparison

Bupivacaine with dexmedetomidine vs bupivacaine with fentanyl

Design

Randomized double-blind prospective comparative study

Key result

Dexmedetomidine as an adjuvant to bupivacaine significantly shortened the onset of sensory blockade compared to fentanyl (8.53 vs 14.80 min; P=0.0001) in patients undergoing upper limb surgeries.

Authors

TSTaiyenjam Kennedy SinghKKKuruva Anil KumarTSTongbram Yashobanta Singh

Discussion

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Overview

Ultrasound may improve supraclavicular block safety; leaves open need for larger RCTs before changing practice.

Study Design

Type

RCT (n=60)

Blinding

Double-blind

Randomization

Randomized

Structured PICO

Does dexmedetomidine compared to fentanyl as an adjuvant to bupivacaine improve the onset and duration of supraclavicular brachial plexus block in patients undergoing upper limb surgeries?

P
Population
60 patients undergoing upper limb surgeries.
I
Intervention
0.5% bupivacaine (1.5 mg/kg) with 1 mcg/kg dexmedetomidine (Group BD, n=30)
C
Comparator
0.5% bupivacaine (1.5 mg/kg) with 1 mcg/kg fentanyl (Group BF, n=30)
O
Outcome
Onset of sensory and motor blockade, and total duration of sensory, motor blockade, and analgesiasurrogate

Main Result

Absolute Event Rate: 8.53% vs 14.8%

p-value: p=0.0001

Dexmedetomidine is superior to fentanyl as an adjuvant to bupivacaine in shortening the onset and prolonging the duration of supraclavicular brachial plexus block for upper limb surgeries.

Cite This Study

Singh et al. (2023) conducted an RCT in Upper limb surgeries (n=60). Dexmedetomidine vs. Fentanyl (1 mcg/kg) was evaluated on Onset of sensory blockade (minutes) (p=0.0001). Dexmedetomidine as an adjuvant to bupivacaine significantly shortened the onset of sensory blockade compared to fentanyl (8.53 vs 14.80 min; P=0.0001) in patients undergoing upper limb surgeries.

synapsesocial.com/papers/6aa0f07e8b7ad710eb4f80a5https://doi.org/10.4103/jms.jms_72_23
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