International Journal of Medical Sciences and Education (IJMSE)
Vol. 8 Issue: 4 (Oct-Dec 2021), Date of Publication: 01.01.2022

1.  EFFECT OF ADDITION OF DEXMEDITOMIDINE TO 0.5% ROPIVACAINE OR 0.5% ROPIVACAINE IN AXILLARY ROUTE BRACHIAL PLEXUS BLOCK IN HAND AND FOREARM SURGERY                         1-6

 Dr Abeezar Hussain                                                                                                                PDF FULL TEXT

ABSTRACT

Background- The present evidence supports the addition of  50mcg /kg Dexmedetomidine in moderate doses to potentiate the efficacy of peripheral nerve blocks without increasing risks of adverse events. Thus present study was designed to compare the role of  addition of  Dexmedetomidine to  Ropivacaine 0.5% or Ropivacaine 0.5%  alone  in axillary route brachial plexus block in hand & forearm surgery. Method- 60 study subjects scheduled to undergo hand & forearm surgery in ASA grade I & II were randomised into two groups Group R (n=30) and Group II (n=30).  In  Group I subjects were administered  Ropivacaine 0.5 %  15 ml, normal saline 5ml (Total 20 ml)  (n=30) and in Group II subjects were administered Ropivacine 0.5%  15 ml , normal saline 4ml + 50mcg /kg Dexmedetomidine 1 ml  (Total 20 ml)  (n=30) . Intergroup comparison  made for  hemodynamic parameters , onset of sensory block & motor block,duration of sensory & motor block,  total duration of analgesia and any untoward events.  Results- At baseline ,the demographics & hemodynamic parameters  were comparable(p>0.05). The onset of sensory block in Group RD (17±4.97 min)  was attained faster than Group R (21.4± 2.78 min) was statistically significant(p<0.001). The onset of motor block in Group RD (19±2.879 min ) was achieved faster than in Group R (24.21±.231min )  which was statistically significant (p<0.001). The duration of sensory block , motor block & duration of analgesia in Group RD statistically significantly prolonged (p<0.05). Intergroup comparison showed a significant decline in the HR in Group RD (p < 0.05). Conclusion -  Addition of 50mcg /kg Dexmedetomidine to long acting amide local anaesthetic Ropivacaine 0.5% hastens the onset of sensory & motor block, lengthens the duration of sensory block, motor block & analgesia. Thus can be effeciently used by anaesthetists in Ropivacaine in axillary route brachial plexus block in hand & forearm surgery with minimal adverse events which are transient & do not require treatemnt.
Keywords – Dexmedetomidine,  Ropivacaine , Axillary brachial plexus , nerve block