Dexmedetomidine is better than tramadol and clonidine in the control of shivering because of its faster onset and less recurrence rate. Though complications are encountered in the dexmedetomidine group, they are treatable.

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Background and Aims: An ideal adjuvant to local anesthetic in a nerve block should prolong the duration of analgesia, and hasten the onset of sensory and motor blockade without significant adverse effects. The aim of this study was to compare morphine, dexmedetomidine, and dexamethasone as an additive to ropivacaine in ultrasound-guided supraclavicular brachial plexus block (SBPB) for postoperative analgesia. Material and Methods: In this randomized, double-blinded study, 150 patients undergoing upper extremity surgery were randomly divided into three groups: group A (morphine 5 mg), group B (dexmedetomidine 50 μg), and group C (dexamethasone 8 mg). The additives were added to 30 ml of 0.5% ropivacaine solution and administered in SBPB. The duration of postoperative analgesia, onset of sensory and motor blockade, sedation, and adverse effects were observed. The pain was assessed by visual analog scale (VAS) and sedation by Ramsay sedation score. The duration of postoperative analgesia was taken as time consumed from block completion to administration of rescue analgesia (VAS >3). Results: The demographic profile was similar in both groups. The duration of analgesia was significantly longer in dexamethasone (867.2 ± 217.6 min) than morphine (739. 2 ± 162.5 min) and dexmedetomidine (654.2 ± 179.9 min) ( P < 0.001). The onset of sensory and motor blockade was quicker with dexmedetomidine than dexamethasone and morphine. Three cases of block failure were reported with morphine. No major adverse effects were reported. Conclusion: Dexamethasone is an ideal adjuvant to ropivacaine in brachial plexus block to prolong postoperative analgesia and devoid of adverse effects. Dexmedetomidine has a quicker onset of sensory and motor blockade.

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Background and Aims: Quadratus lumborum block (QLB) is a novel anaesthetic technique for abdominal wall block providing excellent post-operative analgesia. The primary objective of this study was to evaluate the duration of post-operative analgesia with QLB in unilateral laparoscopic renal surgeries. The secondary objectives were to assess total morphine consumption during the first 24 h postoperatively and observe for complications. Methods: Sixty patients undergoing unilateral laparoscopic renal surgeries were randomly divided into two groups, with patients receiving QLB (Group A) or no block (Group B) at the end of surgery. General anaesthesia was standardised in both the groups. The pain was assessed by a Visual Analogue Scale (VAS) of 1–10. The duration of analgesia was taken as time from extubation to VAS of ≥3. Morphine was administered in patient-controlled analgesia pump with a bolus of 1 mg and a lockout interval of 10 min (min). The total morphine consumption was recorded. The statistical analysis was performed with the Student's t -test and Chi-square test. Results: The duration of post-operative analgesia was significantly prolonged in Group A (1288 ± 288.92 min) than Group B (138 ± 54.92 min). Morphine consumption was also less in Group A (3.1 ± 0.87 mg) than Group B (10.46 ± 1.8 mg). There was a significant difference in the VAS score from 16 to 20 h. No complications were recorded. Conclusions: Ultrasound-guided QLB after laparoscopic renal surgery is safer to perform, effective with an increased post-operative duration of analgesia, reduces the consumption of opioids and is associated with fewer side effects.