Key result
Adding dexmedetomidine to bupivacaine prolongs supraclavicular block analgesia by ~512 minutes.
Why the study?
The effect of adding dexmedetomidine to bupivacaine for supraclavicular block was investigated to assess potential benefits in onset and duration of block and analgesia.
Does adding dexmedetomidine to bupivacaine improve block characteristics and prolong analgesia in patients undergoing elective upper limb surgeries?
RCT (n=70)
Double-blind
Random number table using a sealed envelope technique
No
Does adding dexmedetomidine to bupivacaine improve block characteristics and prolong analgesia in patients undergoing elective upper limb surgeries?
Absolute Event Rate: 722% vs 210%
p-value: p=<0.0001
Adding dexmedetomidine to bupivacaine for supraclavicular block significantly accelerates onset and prolongs the duration of sensory and motor block and analgesia.
Supports adjunctive dexmedetomidine for upper-limb regional anesthesia; extends RCT evidence on alpha-2 agonists in peripheral blocks.
BACKGROUND: The benefits of regional anesthetic techniques are well established. Use of additives to local anesthetics can prolong these benefits. The aim of this study was to find out the effect of adding dexmedetomidine to bupivacaine for supraclavicular block. METHODS: In this randomized, double-blind study, 70 ASA I & II patients of either sex undergoing elective surgeries on the upper limb were given supraclavicular block under ultrasound guidance. Group C (n=35) received 38 mL 0.25% bupivacaine + 2mL normal saline and group D received 38 mL 0.25% bupivacaine + 1 µg/kg dexmedetomidine (2mL). Patients were observed for, onset of motor and sensory block, duration of motor and sensory block, duration of analgesia, sedation score, hemodynamic changes and any adverse events. RESULTS: In group D, the onset was faster (P< 0.001), durations of sensory and motor block duration of and analgesia were prolonged as compared to group C (P < 0.0001).There was a significant drop in heart rate (HR) from the baseline in group D (P < 0.05) at 30, 60, 90 and 120 min. However, none of the patients dropped HR below 50/min. Mean Arterial Pressure (MAP) remained unaffected. The patients in group D were more effectively sedated than those in group C (P < 0.05). No adverse event was reported in either group. CONCLUSION: Dexmedetomidine as adjuvant to bupivacaine in supraclavicular block resulted in faster action, prolonged motor and sensory block, prolonged analgesia with hemodynamic stability and adequate sedation.
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Nazir et al. (2016) conducted an RCT in Elective upper limb surgeries (n=70). Dexmedetomidine vs. Normal saline (placebo) was evaluated on Duration of analgesia (time to first analgesic request) (p=<0.0001). Adding dexmedetomidine to bupivacaine in supraclavicular block significantly prolonged the duration of analgesia to 722 minutes compared to 210 minutes with bupivacaine alone.
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