Background: The supraclavicular brachial plexus block is a commonly employed regional anesthetic techniquefor upper limb surgeries. Ropivacaine, a long-acting local anesthetic, is frequently used in this block. To enhanceits efficacy and duration, various adjuvants such as opioids and α2-adrenergic agonists are used. This studycompares the efficacy of dexmedetomidine versus fentanyl as adjuvants to ropivacaine (0.75%) in supraclavicularbrachial plexus block.Objectives: To evaluate and compare the onset, duration, and quality of sensory and motor block, as well aspostoperative analgesia and side-effect profile of dexmedetomidine and fentanyl when used with ropivacaine(0.75%).Methods: A randomized, double-blind comparative study was conducted on 120 patients scheduled for upperlimb surgeries under supraclavicular brachial plexus block. Patients were randomly divided into two groups:Group RD (n=60) received 30 mL of 0.75% ropivacaine with 1 μg/kg dexmedetomidine, and Group RF (n=60)received 30 mL of 0.75% ropivacaine with 1 μg/kg fentanyl. Onset and duration of sensory and motor block,duration of analgesia, hemodynamic changes, and adverse effects were recorded.Results: Group RD showed significantly faster onset and longer duration of both sensory and motor blockcompared to Group RF. Duration of postoperative analgesia was significantly prolonged in the dexmedetomidinegroup. Hemodynamic stability was better maintained in Group RD, with fewer incidences of nausea and vomiting compared to Group RF.Conclusion: Dexmedetomidine as an adjuvant to 0.75% ropivacaine in supraclavicular brachial plexus blockprovides superior block characteristics and longer postoperative analgesia than fentanyl, with a better safetyprofile.
Prasad et al. (Thu,) studied this question.