To compare efficacy and safety of two different doses of Dexmedetomidine as an adjuvant to Ropivacaine compared to Ropivacaine in block and intravenously Dexmedetomidine in upper limb surgeries under supraclavicular brachial plexus block.

Abstract

To compare efficacy and safety of two different doses of Dexmedetomidine as an adjuvant to Ropivacaine compared to Ropivacaine in block and intravenously Dexmedetomidine in upper limb surgeries under supraclavicular brachial plexus block.
INTRODUCTION
Supraclavicular block is a reliable, rapid-onset approach to brachial plexus anaesthesia. The supraclavicular block provides anesthesia and analgesia to the upper extremity below the shoulder. It is an excellent choice for elbow and hand surgery. Adjuvants are added to local anesthetics in peripheral nerve blocks to fasten the onset of action, to prolong the duration of action and improve the quality of blockade. Various adjuvants like morphine, fentanyl, sufentanil, clonidine, midazolam, ketamine, neostigmine, dexmedetomidine are added to local
anesthetics. Since dexmedetomidine has α2:α1 selectivity ratio of 1620:1 as compared to 220:1 for clonidine, it decreases unwanted side effects of α1 and much more sedative and analgesic. Ropivacaine is a long-acting amide local anaesthetic agent and first produced as a pure enantiomer structurally related to Bupivacaine. Dexmedetomidineis d-enantiomer of medetomidine. It belongs to imidazole subclass of α2 receptor agonist. It is a newer α2-adrenoreceptor agonist is currently in focus for its sedative, anxiolytic and analgesic properties.It is rapidly distributed and metabolized in liver, excreted in urine and faeces.