Efficacy of dexmedetomidine and fentanyl as adjuvants to 0.75% ropivacaine in supraclavicular brachial plexus block- a comparative study

Author: 
Sonal Khatavakar, Balkees Beevi .N and Divya Tewari.

Context: Supraclavicular Brachial Plexus block is popular in upper limb surgeries. Peripheral Nerve stimulation increases the success and accuracy with less complications. Local anaesthetic (LA) Ropivacaine has less cardio toxicity than Bupivacaine. Adjuvants are added to (LA) to increase quality and duration of blockade while reducing its toxicity.
Aim: To compare onset, duration of sensory and motor block by using 0.75% Ropivacaine with adjuvants Dexmedetomidine and Fentanyl in Supraclavicular block. Purpose of this study is to find duration of post-op analgesia and associated side effects.
Methods and Material: 60 patients of ASA grade 1,2aged 18-65 years of either sex undergoing elective upper limb surgery, randomlydivided into 2 groups of 30 each.
• Group RF: Inj. Ropivacaine 0.75% (24ml) + Inj. Fentanyl 50 mcg (1ml)
• Group RD: Inj. Ropivacaine 0.75% (24ml) + Inj. Dexmedetomidine 50 mcg (1ml)
Statistical analysis: Software package SPSS v20.0 used. Mann-Whitney U test was used to compare non parametric data.
Results: In group RF/RDin minutes respectively for Peak sensory block 9.9± 4.2/13.3±4.9 (p Value-0.002). Peak motor block 15.7±4.7/20.6±7.3(p Value-0.009).Total duration of sensory block 464.0±47.3/784.0±47.4 (p Value< 0.001).Total duration of motor block 456.3 ± 51.0/756.3 ± 51.1(p Value< 0.001). Time required for post op rescue analgesia was longer in RD group.
Conclusion: Dexmedetomidine provides a longer duration of sensory and motor blockade and post-operative analgesia when compared to Fentanyl as an adjuvant to 0.75%Ropivacaine in Supraclavicular block.

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DOI: 
http://dx.doi.org/10.24327/ijcar.2022.951.0215
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