Effect of Dexmedetomidine as an Adjuvant in Supraclavicular Brachial Plexus Block with Ropivacaine: A Prospective, Double blinded and Randomized Controlled Study

Introduction: Different types of additives are commonly used to prolong the duration of brachial plexus block.The present study was aimed to test the hypothesis that dexmedetomidine produces a superior analgesia, motor block and post operative analgesia when added as an adjuvant to ropivacaine 0.5% in supraclavicular brachial plexus block. Materials andMethods: A total of 100 patients (20-50 years) posted for elective forearm and hand surgery under supraclavicular brachial plexus block were divided into two equal groups (Group R and RD) in a randomized, double-blind fashion. In group RD (n = 50) 30 ml 0.5% ropivacaine plus 1 ml (100 micrograms) of dexmedetomidine and group R (n = 50) 30 ml 0.5% ropivacaine plus 1 ml normal saline were administered in supraclavicular block. Sensory and motor block onset times and block durations, time to first analgesic use, total analgesic need, postoperative visual analog scale (VAS), hemodynamics and sideeffects were recorded for each patient. Results: Though with similar demographic profile in both groups, sensory and motor block in group RD (P < 0.05) was earlier than group R. Sensory and motor block duration and time to first analgesic use were significantly longer and the total need for rescue analgesics were lower in group RD (P < 0.05) than group R. Post-operative VAS value at 12 h was significantly lower in group RD (P < 0.05). Intra-operative hemodynamics were significantly lower in group RD (P < 0.05) without any adverse side-effects. Conclusion: It was concluded that addition of dexmedetomidine to supraclavicular brachial plexus block increases the sensory and motor block duration and time to first analgesic use, and decreases total analgesic use with no side-effects