Dexmedetomidine as an Adjuvant to Ropivacaine in Ultrasound Guided Brachial Plexus Block Using Supraclavicular Parasagittal Approach for Upper Limb Orthopedic Surgeries

Mahima K Balakrishnaiah; Karthik G. Sheshadri; Sudheer Ramegowda; Shivasharn K Hosalli; Kishore Kumar; Sharieff Sameer Ahmed

doi:10.18502/aacc.v8i3.9616

Mahima K Balakrishnaiah Department of Anaesthesiology, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India.
Karthik G. Sheshadri Department of Anaesthesiology, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India.
Sudheer Ramegowda Department of Anaesthesiology, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India.
Shivasharn K Hosalli Department of Anaesthesiology, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India.
Kishore Kumar Department of Anaesthesiology, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India.
Sharieff Sameer Ahmed Department of Anaesthesiology, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India.

DOI: https://doi.org/10.18502/aacc.v8i3.9616

Keywords: Dexmedetomidine; Parasagittal; Ropivacaine; Supraclavicular brachial plexus block; Ultrasound

Abstract

Background: Brachial plexus block is a key technique in anesthesiologist’s practice. Ropivacaine is a long acting local anaesthetic, Dexmedetomidine has been included as an adjuvant to enhance block duration.

Aim: To elucidate the effect of addition of Dexmedetomidine to Ropivacaine in ultrasound guided parasagittal supraclavicular brachial plexus approach with respect to duration of analgesia, onset and duration of sensorimotor blockade.

Methods: A randomized single blinded prospective clinical study was conducted among Forty patients of 20-50yrs, ASA Grade I and II, weighing >60kgs scheduled for elective upper limb orthopedic surgeries. Group RN received 25ml of 0.75% ropivacaine with 1ml normal saline, Group RD received 25ml of 0.75% ropivacaine with 1mcg/kg dexmedetomidine diluted to 1ml. Analgesic efficacy, sensorimotor blockade was determined.

Statistical Analysis: Demographic and hemodynamic data was analyzed using student t-test. Unpaired t-test was used to analyze onset, duration of sensorimotor blockade and analgesic duration. Results were statistically significant if p-value <0.05. P-value <0.001 was considered highly significant.

Results: Analgesic duration was prolonged in Group RD rather than Group RN (646.82 +/- 21.56min vs 484.78 +/- 15.52min). Group RD had rapid onset of sensory (7.4 +/- 1.02min vs 9.9 +/- 1.16min) and motor blockade (10.25 +/- 1.13min vs 13.28+/- 1.22min). Duration of sensory (536.62 +/- 9.61min vs 413.79 +/- 15.61min) and motor blockade (430.13 +/- 11.68min vs 298.12 +/- 15.36min) was enhanced in Group RD.

Conclusion: Adding Dexmedetomidine to Ropivacaine provided superior analgesia along with rapid onset and longer duration of sensorimotor blockade.