Abstract

Perineural adjuvants when used as a part of Supraclavicular Brachial Plexus Block will maximize the quality and duration of analgesia of the nerve blocks. In the present study, we compared the duration of postoperative analgesia and postoperative Requirement of rescue analgesia for two groups comprising either Dexamethasone + Buprenorphin and Dexamethasone +Dexmedetomidine as A Dual Adjuvant in the upper limb surgeries performed under ultrasound‑guided (US‑guided) supraclavicular brachial plexus blocks. Materials and Methods: In this Randomised comparative clinical study 40 patients randomly divided in two groups. Each group contains 20 patients. GROUP 1: inj. Bupivacaine (0.25%) 30ml+inj.Buprenorphine 0. 5ml+inj.Dexamethasone 1 ml. GROUP 2: Inj.Bupivacaine (0.25%) 30ml+inj.dexamethasone 1ml+inj.Dexmedetomidine0.5ml. volume not exceeding 31.5ml. Intraoperative standard monitoring including ECG, SpO2, PR and noninvasive blood pressure were done. Intravenous access was secured with 18-G cannula on the contralateral hand and 0.04 mg/kg midazolam was administered to all patients as a premedication and oxygen was delivered via facemask at a rate of 6 lit/min. Results: Postoperative duration of sensory blockade between Buprenorphine+ Dexamethasone and Dexmedetomidine+Dexamethasone contains significant P value (<0.001) and Postoperative duration of motor blockade between Buprenorphine+Dexamethasone and Dexmedetomidine+Dexamethasone contains significant P value (<0.001). Postoperative Requirement of rescue analgesia for two groups with P Value(0.06). Conclusion: For surgeries under USG Guided Supraclavicular brachial plexus block, perineural Dexmedetomidine+Dexamethasone when used as a dual adjuvant provided a prolonged duration of postoperative sensory and motor blockade and less requirement of postoperative rescue analgesia.

Description