DOI: http://dx.doi.org/10.18203/2349-3259.ijct20182060

A randomised prospective comparative study of evaluation of dexmedetomidine an adjuvant to ropivacaine for ultrasound guided supraclavicular block

V. S. S. N. Murthy, N. Hari Kiran Verma, Anand Acharya

Abstract


Background: There are clinical evidences for efficacy of dexmedetomidine as an adjuvant to local anaesthetic for peripheral nerve block, but very few published study are available on continuation of dexmedetomidine, with ropivacaine for ultrasound guided supraclavicular block. The present study has been designed to elucidate the effect of dexmedetomidine, in combination ropivacaine on various parameters.

Methods: During period of 2 year and 3 months 84 patients were enrolled for this study. Patient in Group A were received 15 ml of 0.5% ropivacaine with 100 microgram one ml dexmedetomidine and Group B were received 15ml of 0.5% of ropivacaine with 1 ml of normal saline. Drug solution was prepared by same individual and was not part of study.

Results: Both the group were comparable to each other regarding demography profile. The duration of sensory block 644.96±72.4 min in group A and the duration of sensory block in Group B was 731.53±131.54 min with p value 0.00354. The duration of motor block was 661.5±29.25 in group A and 559.77±29.25 in Group B with P value 0.0001. Duration of analgesia in Group A was 457.06±34.47 min and it was 345.70±38.032 min in Group B. The supplementation of intravenous opioid was required in 3 patients in Group A and 10 patients in group B with P value 0.037.

Conclusions: When 100 microgram of dexmedetomidine was added as an adjuvant to ropivacaine is associated with early onset of sensory and motor block, prolongation of sensory and motor block and duration of analgesia in comparison with ropivacaine alone.


Keywords


Dexmedetomidine, Ropivacaine, Ultrasound guided, Supraclavicular block

Full Text:

PDF

References


Carlo D. Franco, Manual of Regional Anesthesia Chicago, IL, Third Edition, 2008. Available at: www.CookCountyRegional.com. Accessed on 3 January 2018.

Kulenkampff D, Brachial plexus anaesthesia: its indications, techniques and dangers. Ann Surg 1928;87:883–8.

Hanumanthaiah D, Vaidiyanathan S, Garstka M, Szucs S, Iohom G. Ultrasound guided supraclavicular block, Med Ultrason. 2013;15(3):224-9.

DeKrey JA, Schroeder CF, Buechel DR. Continuous brachial plexus block. Anaesthesiology 1969;30:332

Sarnoff SJ, Sarnoff LC. Prolonged peripheral nerve block by means of indwelling plastic catheter: treatment of hiccup.Anesthesiology 1951;12:270–5.

Melissa D. Sinclair A review of the physiological effects of α2-agonists related to the clinical use of medetomidine in small animal practice,Can Vet J. 2003;44(11):885–97.

Gertler R, Brown HC, Mitchell DH, Silvius EN. Dexmedetomidine: a novel sedative-analgesic agent. Proc Bayl Univ Med Cent. 2001;14(1):13–21.

Rosner B., Fundamentals of Biostatistics. 7th ed. Boston, MA: Brooks/Cole; 2011.

Holliday MA, Segar WE. The maintenance need for water in parenteral fluid therapy. American Academy of Pediatrics. Pediatrics 1957;19:823-2.

Hollmén A. Axillary plexus block. A double blind study of 59 cases using mepivacaine and LAC‐43. Acta Anaesthesiologica Scandinavica. 1966;10(Suppl. XXI):53–65.

Bromage PR. Epidural Analgesia. Philadelphia: WB Saunders; 1978: 144.

Katz J1, Melzack R. Measurement of pain. Surg Clin North Am. 1999;79(2):231-52.

Koraki E, Stachtari C, Kapsokalyvas I, Stergiouda Z, Katsanevaki A, Trikoupi A. Dexmedetomidine as an adjuvant to 0.5% ropivacaine in ultrasound-guided axillary brachial plexus block. J Clin Pharm Ther. 2018;43(3):348-52.

Das A, Majumdar S, Halder S, Chattopadhyay S, Pal S, Kundu R. Effect of dexmedetomidine as adjuvant in ropivacaine-induced supraclavicular brachial plexus block: A prospective, double-blinded and randomized controlled study. Saudi J Anaesth. 2014;8(Suppl 1):S72–7.

Marhofer D, Kettner SC, Marhofer P, Pils S, Weber M, Zeitlinger M. Dexmedetomidine as an adjuvant to ropivacaine prolongs peripheral nerve block: a volunteer study. Br J Anaesthesia. 2013;3:438–42.

Gurajala I, Thipparampall AK, Durga P, Gopinath R. Effect of perineural dexmedetomidine on the quality of supraclavicular brachial plexus block with 0.5% ropivacaine and its interaction with general anaesthesia. Indian J Anaesthesia. 2015;59(2):89-95.

Zhang Y, Wang CS, Shi JH, Sun B, Liu SJ, Li P, et al. Perineural administration of dexmedetomidine in combination with ropivacaine prolongs axillary brachial plexus block. Int J Clin Exp Med. 2014;7:680-5.

Swami SS, Keniya VM, Ladi SD, Rao R. Comparison of dexmedetomidine and clonidine (a2 agonist drugs) as an adjuvant to local Anesthesia in supraclavicular brachial plexus block: A randomised double-blind prospective study. Indian J Anaesth. 2012;56:243-9.

Andersen JH1, Grevstad U, Siegel H, Dahl JB, Mathiesen O, Jæger P. Does Dexmedetomidine Have a Perineural Mechanism of Action When Used as an Adjuvant to Ropivacaine? A Paired, Blinded, Randomized Trial in Healthy Volunteers. Anesthesiology. 2017;126(1):66-73.

Kathuria S, Gupta S, Dhawan I. Dexmedetomidine as an adjuvant to ropivacaine in supraclavicular brachial plexus block. Saudi J Anaesthesia. 2015;9(2):148-54.