Association Dexmedetomidine and Dexamethasone as an Adjuvant to Levobupivacaine for Supraclavicular Brachial Plexus Block in Patients Undergoing Upper Limb Surgeries.

Abstract

Introduction: Brachial plexus block has evolved into an excellent substitute to general anaesthesia for upper limb surgeries. By curtailing the 1 stress response and using minimal anaesthetic drugs it provides intraoperative analgesia along with prolonged postoperative pain-relief. Varied avenues of brachial plexus blockade exist namely interscalene, supraclavicular, infraclavicular and axillary approach. With swift onset of dense anaesthesia of upper limb, supraclavicular brachial plexus block (SCBP) block is considered as the 'spinal of the arm. Objective: To conduct a comparative evaluation between Dexmedetomidine and Dexamethasone as an adjuvant to Levobupivacaine for supraclavicular brachial plexus block inpatients undergoing upper limb surgeries. Material and Methods: This is a prospective randomized controlled intervention study was Patients undergoing elective upper limb surgeries under supraclavicular brachial plexus block at orthopaedic surgery rooms of MGM Medical College From March 2019 to August 2020 Patients aged between 20-60 years of either sexes. Patients belonging to ASA Grade I and ASA Grade II and Patients scheduled for elective upper limb surgeries under supraclavicular brachial plexus block in included in this study. Result: The mean Onset of sensory block (mean± s.d.) of patients was higher in Group-C [13.2333± 1.6333 Mins] compared to Group-S patients [11.2000± 1.1265(Min)] which was statistically signicant (p<0.0001). the mean Duration of Sensory Block (mean± s.d.) of patients was higher in Group-S [753.5667± 5.2172 (Min)] compared to Group-C patients [718.2333± 25.7504 (Min)] which was statistically signicant (p<0.0001). the mean Duration of Motor Block (mean± s.d.) of patients was higher in Group-S [708.5667± 4.2644 (Min)] compared to Group-C patients [682.3667± 20.0095 (Min)] which was statistically signicant (p<0.0001). Conclusion: The difference of mean Fingers 0 (p=0.6311), Fingers 5 (p=0.8860), Fingers 10 (p=1.0000), Fingers 15 (p=1.0000), Fingers 20 (p=1.0000), Fingers 25 (p=0.5936) and Fingers 30 (p=0.8469) with both Groups were not statistically signicant. Bromage Score 0 (p=0.8469), Bromage Score 5 (p=0.8355), Bromage Score 10 (p=0.5693), Bromage Score 15 (p=0.5671), Bromage Score 20 (p=0.5671), Bromage Score 25 (p=0.6973) and Bromage Score 30 (p=0.7176) with both Groups were not statistically signicant.