A Comparative Study of Peripheral Nerve Stimulated Guided Supraclavicular Brachial Plexus Block Using Bupivacaine -Lignocaine with Adrenaline & Dexmedetomidine added to Bupivacaine - Lignocaine with Adrenaline.
PDF Downloads : 10    VIEW PDF

Keywords

supraclavicular brachial plexus block
Sensory block
Motor block
Dexmedetomedine

How to Cite

Pawar, D. A. B. ., & Rawat, D. H. S. (2018). A Comparative Study of Peripheral Nerve Stimulated Guided Supraclavicular Brachial Plexus Block Using Bupivacaine -Lignocaine with Adrenaline & Dexmedetomidine added to Bupivacaine - Lignocaine with Adrenaline. VIMS Health Science Journal , 5(2), 66-70. Retrieved from https://vimshsj.edu.in/index.php/main/article/view/109

Abstract

Background: Alpha-2 agonists are mixed with local anaesthetic agents to extend the duration of spinal, extradural and peripheral nerve blocks. We add Dexmedetomidine as an adjuvants to local anaesthetic in supraclavicular brachial plexus block with respect to onset and duration of sensory and motor block and duration of analgesia. Methodology: A randomized prospective observational clinical study was carried out on 60 American Society of Anaesthesiologist (ASA) Grade I and II patients of either sex, aged 18–50 years, undergoing various bony orthopaedic surgeries on the upper limb under supraclavicular brachial plexus block. The study was conducted in two groups of 30 patients each , group 1: Patients received 0.5% Bupivacaine (15ml) + 2% Lignocaine with Adrenaline (15ml) + 2 ml of 7.5% (w/v) Sodium bicarbonate + normal saline (0.5ml) ,group 2: Patients received 0.5% Bupivacaine (15ml) + 2% Lignocaine with Adrenaline (15ml) +2 ml of 7.5% (w/v) Sodium bicarbonate + Dexmedetomidine (0.5ml). Results: The onset of sensory block and duration of sensory block was 5.83 ± 1.5 and 690 ± 87 min, respectively, in group 2 and onset of motor block and duration of motor block was 8.43 ± 1.5 and 353.17 ± 42.41, respectively, in group 2 which was statistically highly significant as compared to group 1 which was 8.83 ± 1.01 and 386 ± 42.33 for onset of motor block and duration of sensory block respectively and 11.53 ± 1.75 and 270 ± 31.6 for the onset of motor block and duration of motor block in group 2, respectively. The need for the rescue analgesia was 456.21 ± 97.99 in group 2 and 289.67 ± 62.50 in group 1, which was also highly significant. Conclusion: Dexmedetomedine, when added to local anaesthetic in supraclavicular brachial plexus block prolongs the duration of sensory and motor block and enhances the quality of block. The time for rescue analgesia was prolonged in patients receiving Dexmedetomidine.

PDF Downloads : 10    VIEW PDF

References

Swami SS, Keniya VM, Ladi SD, Rao R. Comparison of dexmedetomidine and clonidine (a2 agonist drugs) as an adjuvant to local anaesthasia in supraclavicular brachial ‘study. Indian Journal of Anesthesia. 2012;56(3): 243-249. doi: 10.4103/0019-5049.98767.

Jones ME, Maze M. Can we characterize the central nervous system actions of alpha-2 adrenergic agonists? Br J Anaesth 2001;86(1): 1-3.

Derbyshire DR, Chmielewski A, Fell D, et al. Plasma catecholamine respons to tracheal intubation. Br J Anaesth 1983;55(9): 855-859.

Brummett CM, Norat MA, Palmisano JM, et al. Perineural administration of dexmedetomidine in combination with bupivacaine enhances sensory and motor blockade in rat. Anesthesiology 2008; 109(3): 502-511.

Eisenach JC, De Kokc M, Kilmscha W. Alpha (2)-adrenergic agonists for regional anesthesia. A clinical review of clonidine (1984-1995). Anesthesiology 1996;85(3): 655-674.

Halaszynski, T.M. 2012. Dexmedetomidine: A look at a promising new avenue of use. Saudi J Anaesth, 6: 104-6.

Esmaoglu A, Yegenoglu F, Akin A, Turk, C.Y. 2010. Dexmedetomidine added to Levobupivacaineprolongs axillary brachial plexus block. AnaesthAnalg., 111:1548-51.

Brummett, C.M., Norat, M.A., Lydic, R. 2008. Perineural administration of dexmedetomidinein combination with bupivacaine enhances sensoryand motor blockade in sciatic nerve block withoutinducing neurotoxicity in rat. Anesthesiology, 109:502-11.

Dr. Ruby Mehta, Dr. D.D. Verma, Dr. Veena Gupta , Dr. A.K. Gurwara. TO STUDY THE EFFECT OF ALKALINIZATION OF LIGNOCAINE HYDROCHLORIDE ON BRACHIAL PLEXUS BLOCK, Indian J. Anaesth. 2003; 47(4): 283-286: AL

Bisui B, Samanta S, Ghoshmaulik S, Banerjee A, Ghosh TR, Sarkar S. Effect of Locally Administered Dexmedetomidine as Adjuvant to Levobupivacaine in Supraclavicular Brachial Plexus Block: Double – blind Controlled Study. Anesthesia, Essays and Researches. 2017;11(4): 981-986. doi:10. 4103/aer.AER_55_17.

Thakur A, Singh J, Kumar S, Rana S, Sood P, Verma V. Efficacy of Dexmedetomidine in two Different Doses as an Adjuvant to Lignocaine in Patients Scheduled for Surgeries under Axillary Block. Journal of Clinical and Diagnostic Research 2006;40(2)116-118.

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Downloads

Download data is not yet available.