Background: Supraclavicular approach of brachial plexus block (BPB) has been in popular choice in recent years for surgical, diagnostic, and therapeutic management of injury and pathology related to upper limb. Aims and Objectives: In this study, we investigated the effect of dexmedetomidine and fentanyl as an adjuvant to bupivacaine on quality of block and post-operative analgesia in perineural supraclavicular BPB. Materials and Methods: A prospective, randomized, and triple-blind study was done involving 70 patients of age 18–60 years, randomly allocated into two equal groups [group BD- bupivacaine (0.5%) 29 ml with 100 μg (1 ml) of dexmedetomidine and group BF - bupivacaine (0.5%) 29 ml with 50 μg (1 ml) of fentanyl]. The scores of modified Gormley and Hill scale, modified Bromage scale, Ramsay sedation scale, and rescue analgesic requirement were recorded along with hemodynamic parameters. Pearson’s Chi-square test and Mann–Whitney U test were used for statistical analysis. Results: The onset time of sensory and motor blockade was shortened and the duration of the block was significantly prolonged in the BD Group than BF Group (P<0.001). The duration of post-operative analgesia was also longer in the BD Group compared with the BF Group (549.43±10.56 vs. 403.69±10.84) P<0.001. BF Group had more requirements of analgesic postoperatively. Conclusion: Addition of dexmedetomidine to bupivacaine prolonged the duration of perineural supraclavicular BPB and improvement of post-operative analgesia than fentanyl without significant side effects in patients undergoing upper limb surgeries.

Background: Long duration neurosurgical procedures require the use a relatively longer acting analgesic which will give equianalgesia like a short-acting opioid without needing repeated administration or an infusion. Aims and Objectives: In this study, we investigated and compared the intraoperative analgesic efficacy and post-operative recovery outcome of intravenous (IV) butorphanol and IV nalbuphine in non-emergency craniotomy patients. Materials and Methods: A prospective, randomized, and double-blind study was conducted involving 60 patients of age 18–50 years, randomly assigned into two equal groups receiving either 1 mg butorphanol IV (Group B) or 10 mg nalbuphine IV (Group N) 10 min before induction of general anesthesia. Patients were monitored for changes in blood pressure, heart rate (HR) perioperatively and duration of analgesia, and Ramsay Sedation Score (RSS) postoperatively. The results were recorded and analyzed statistically using Pearson’s Chi-square test for Independence of Attributes/Fisher’s Exact Test and Student’s t-test for continuous variables. Results: Statistically significant fall in HR and mean blood pressure was seen in both groups during intraoperative period, though fall was more in the nalbuphine group. Duration of analgesia was statistically significant in Group B than Group N (249.27±18.33 vs. 240.13±15.70, P=0.043). Sedation was more with nalbuphine as time to achieve RSS 2 was less with butorphanol. Conclusion: Inj. butorphanol and inj nalbuphine both showed satisfactory result in maintaining hemodynamic stability and long duration of analgesia. When compared, butorphanol provided longer duration of analgesia and less post-operative sedation.