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

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.