A Comparative Study of Dexmedetomidine and Clonidine as an Adjuvant to Bupivacaine in Ultrasound-Guided Supraclavicular Brachial Plexus Block
Authors/Creators
- 1. Assistant Professor, Department of Anaesthesiology, Prathima Institute of Medical Sciences, Naganoor, Karimnagar, Telangana State
Description
Background: For upper limb surgeries, ultrasound-guided brachial plexus block is the preferred technique. Adding adjuvants to peripheral nerve blocks is common to enhance their analgesic effectiveness and duration. In this study, we compared the analgesic effects of dexmedetomidine 1µg/kg and clonidine 1µg/kg as adjuvants to a low volume of bupivacaine in ultrasound-guided supraclavicular brachial plexus block. Methods: A prospective, randomized controlled, double-blind study was conducted after obtaining permission from the institutional ethics committee. We included 40 ASA grade I and II patients, aged 18 to 60 years, who were scheduled for upper limb orthopedic surgery. Group D (Dexmedetomidine group) received 20 ml of bupivacaine along with dexmedetomidine (10 ml of 0.5% bupivacaine + 1µg/kg of dexmedetomidine, diluted with 0.9% NS to 20 ml). Group C (Clonidine group) received 20 ml of 0.25 bupivacaine along with clonidine (10 ml of 0.5% bupivacaine + 1µg/kg of clonidine, diluted with 0.9% NS to 20 ml) in the ultrasound-guided supraclavicular brachial plexus block. Results: The mean age of Group C, receiving bupivacaine with clonidine, had a mean age of 37.5 ± 10.55 years, while Group D, receiving bupivacaine with dexmedetomidine, had a mean age of 35.81 ± 8.55 years. The average time for the onset of sensory block in group C was 12.22 minutes, while in group D, it was 9.55 ± 1.2 minutes. The mean time of onset of motor block in group C was 14.2 ± 1.56 minutes and in group D it was 11.9 ± 0.88 minutes no instances of hypotension or bradycardia were observed in either group. Conclusion: The addition of dexmedetomidine to bupivacaine 0.25% has been found to significantly prolong the pain-free period, duration of motor blockade, and sensory blockade when compared to clonidine or the control group. This combination offers the advantage of maintaining hemodynamic stability while keeping the patient calm. Ultrasound-guided supraclavicular block using a low volume of bupivacaine with 1µg/kg dexmedetomidine resulted in adequate blockade and provided effective postoperative analgesia.
Abstract (English)
Background: For upper limb surgeries, ultrasound-guided brachial plexus block is the preferred technique. Adding adjuvants to peripheral nerve blocks is common to enhance their analgesic effectiveness and duration. In this study, we compared the analgesic effects of dexmedetomidine 1µg/kg and clonidine 1µg/kg as adjuvants to a low volume of bupivacaine in ultrasound-guided supraclavicular brachial plexus block. Methods: A prospective, randomized controlled, double-blind study was conducted after obtaining permission from the institutional ethics committee. We included 40 ASA grade I and II patients, aged 18 to 60 years, who were scheduled for upper limb orthopedic surgery. Group D (Dexmedetomidine group) received 20 ml of bupivacaine along with dexmedetomidine (10 ml of 0.5% bupivacaine + 1µg/kg of dexmedetomidine, diluted with 0.9% NS to 20 ml). Group C (Clonidine group) received 20 ml of 0.25 bupivacaine along with clonidine (10 ml of 0.5% bupivacaine + 1µg/kg of clonidine, diluted with 0.9% NS to 20 ml) in the ultrasound-guided supraclavicular brachial plexus block. Results: The mean age of Group C, receiving bupivacaine with clonidine, had a mean age of 37.5 ± 10.55 years, while Group D, receiving bupivacaine with dexmedetomidine, had a mean age of 35.81 ± 8.55 years. The average time for the onset of sensory block in group C was 12.22 minutes, while in group D, it was 9.55 ± 1.2 minutes. The mean time of onset of motor block in group C was 14.2 ± 1.56 minutes and in group D it was 11.9 ± 0.88 minutes no instances of hypotension or bradycardia were observed in either group. Conclusion: The addition of dexmedetomidine to bupivacaine 0.25% has been found to significantly prolong the pain-free period, duration of motor blockade, and sensory blockade when compared to clonidine or the control group. This combination offers the advantage of maintaining hemodynamic stability while keeping the patient calm. Ultrasound-guided supraclavicular block using a low volume of bupivacaine with 1µg/kg dexmedetomidine resulted in adequate blockade and provided effective postoperative analgesia.
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Additional details
Dates
- Accepted
-
2023-07-18
Software
References
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