A Comparative Study of Ropivacaine Alone Versus Ropivacaine With Dexmedetomidine in Supraclavicular Brachial Plexus Block

Abstract

Background and Aims: Supraclavicular brachial plexus block is frequently used procedure to provide anaesthesia and good post-operative analgesia for surgery on upper limb. The purpose of this study was to compare the hemodynamic, sedative and analgesic effects of ropivacaine alone versus ropivacaine given along with dexmedetomidine.
Materials and Methodology: This prospective, randomized and double-blinded study included total 60 patients of either sex with age between 18-60 years posted for various elective upper limb surgery and randomly allocated into 2 equal groups of 30 each. Control Group-R received injection ropivacaine (0.75%) 30 ml plus 1 ml normal saline and Group-RD received injection ropivacaine (0.75%) 30 ml plus dexmedetomidine 25 µg (1 ml) for supraclavicular brachial plexus block using the peripheral nerve stimulator. Sensory and motor block, monitoring of vitals (systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR)), presence of any side effect, Ramsay sedation score and visual analogue scale or visual analog scale (VAS) score were determined every 5 mins in 1st 30 mins and then every 15 mins during 1st hr followed by every 2nd hourly during 24 hrs.
Results: There was no significant difference in the study groups with regards to demographic profile and duration of surgery. The onset of sensory and motor blockade was faster in Group-RD than Group-R. {Onset of sensory block: (Group-R=14.133±1.676 min and Group-RD=12.667± 1.213 min) (p=0.000), Onset of motor block: (Group-R=25.967±2.748 min and Group-RD=23.333±3.467 min) (p=0.002). Also total duration of sensory blockade {Group-R=547.833±26.152 mins, Group-RD=811.667±25.405 mins (p value=0.000)}, motor blockade {Group-R=509.667±24.703 mins, Group-RD=760.667±28.062 mins (p value=0.000)} and number of rescue injections in 24 hrs {Group-R=2.733±0.450, Group-RD=1.400±0.498 (p value=0.000)} was significantly different in 2 groups. There was good haemodynamic stability in both groups. SBP and DBP in Group-R and Group-RD with p values 0.416 and 0.784 were comparable between the groups. The difference was statistically not significant. There was no incidence of any side effects like hypotension and bradycardia in any of the 60 patients. 
Conclusion: Dexmedetomidine in a dose of 25 µg added to ropivacaine in supraclavicular brachial block for upper limb surgery significantly shortens the onset time and prolongs the duration of sensory and motor block without producing sedation in patients.