Comparative Study of the Efficacy of Dexmedetomidine and Fentanyl as Adjuvants to Ropivacaine in Ultrasound-Guided Supraclavicular Brachial Plexus Block

Dharmarao, Pratibha Shivalgond; Holyachi, Renuka

doi:10.5152/tjar.2018.98058

Cited by 16 publications

(15 citation statements)

References 25 publications

(24 reference statements)

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“…A significant prolongation in duration of sensory and motor block was observed in group D when compared to group F. Present study results also showed that the duration of analgesia is prolonged in group D than group F. These results were comparable to the studies done by P.S. Dharmarao et al 22 , Mohamed et al 23 where they observed that dexmedetomidine prolongs the duration of anesthesia and analgesia when compared to fentanyl. Hemodynamic parameters were similar in all groups.…”

Section: Resultssupporting

confidence: 89%

Comparative Study between Fentanyl and Dexmedetomidine as Adjuvant to Ropivacaine in Brachial Plexus Block

Madhusudhanarao¹

2020

jmscr

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Background: Supraclavicular brachial plexus block is a frequently performed procedure to provide anesthesia and postoperative analgesia for upper limb surgeries. Bupivacaine is the most commonly used anesthetic, but ropivacaine has been successfully used as it is less cardiotoxic, less arrhythmogenic. Adjuvants to local anesthetics enhance the quality and duration of analgesia. Aim: To compare the effects of fentanyl and dexmedetomidine as adjuvants to ropivacaine in brachial plexus block. Materials & Method: After informed consent, sixty ASA I and II patients scheduled for upper limb surgeries under supraclavicular block randomly allocated into two groups of 30 each. GROUP D received 30ml of 0.5% ropivacaine with 20 µg dexmedetomidine and GROUP F received 30ml of 0.5% ropivacaine with 50µg fentanyl. Onset and duration of sensory and motor block, duration of analgesia were compared. Results: Demographic variables were comparable between the two groups. The onset of sensory block in

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Section: Resultssupporting

confidence: 89%

Comparative Study between Fentanyl and Dexmedetomidine as Adjuvant to Ropivacaine in Brachial Plexus Block

Madhusudhanarao¹

2020

jmscr

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“…Dexmedetomidine when added to ropivacaine prolongs the duration of motor blockade as compared to clonidine and fentanyl. Similar results were noted in other studies [9,10,11].…”

Section: Discussionsupporting

confidence: 93%

“…Vallem Balasubramanyam [10], concluded that that dexmedetomidine 1 mcg/kg as an adjuvant result early onset of motor blockade, prolonged duration of motor blockade and with better quality of block as compared to clonidine 1 mcg/kg when added to ropivacaine in supraclavicular brachial plexus block. Dharmarao P and Holyachi R [11], noted that Dexmedetomidine prolongs the duration of motor block as compared to fentanyl but the onset of motor blockade was not statistically significant among the two study groups. While Nyla Farooq [8], noted that fentanyl 1mcg/kg when added to 0.75% ropivacaine was most efficacious than dexem 1mcg/kg when added to 0.75% ropivacaine in onset of motor block having 20 mins for fentanyl group and 30 min in dexem group.…”

Section: Discussionmentioning

confidence: 89%

Comparative Study for Anaesthetic Quality with the Addition of Clonidine, Fentanyl or Dexmedetomidine to 0.5℅ Ropivacaine in Supraclavicular Brachial Plexus Block at a Tertiary Hospital

Naveen¹

2021

J Clin Anesthes Res

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Background: Supraclavicular Brachial plexus block also described as the “spinal of arm”, provides a rapid onset, complete, predictable, and dense anesthesia for the mid humerus, forearm and hand surgery. Brachial plexus block also causes sympathetic block with resultant improvement in blood flow, reduction in vasospasm, and edema which is more favorable for an acute hand injury and reconstructive plastic surgery. In the present study, we compared the anesthetic quality with the addition of either clonidine, fentanyl, or dexmedetomidine to 0.5℅ ropivacaine for supraclavicular brachial plexus block in regard to the onset and duration of sensory/motor block and duration of analgesia at a tertiary hospital. Material and Methods: Present study was the prospective, interventional and comparative study carried out in the department of anaesthesiology, in patients 18-60 years, ASA grade1/2, Mallampati grades 1 and 2, posted for elective upper limb surgeries. 60 patients were randomly divided into three groups, each group includes 20 patients, (Group D- Dexmedetomidine, C- Clonidine, F- Fentanyl). Results: 60 patients scheduled to undergo elective upper limb surgeries were randomly divided into three groups (Group D, C, F), each group includes 20 patients. Age, gender, ASA status, weight, height and mean duration of surgery were comparable in three groups and the difference was statistically insignificant. The difference between the onset of sensory blockade, mean time of onset of complete sensory blockade, duration of complete sensory blockade was found to be statistically significant. Intergroup analysis in groups D, C and F for the onset of sensory blockade, onset of complete sensory blockade and duration of complete sensory blockade in three different groups noted a statistically significant difference. The difference for the onset of motor blockade, the onset of complete motor blockade and duration of motor blockade was found to be statistically significant as (p<0.05), there is a difference noted between Group D, C, and F. Intergroup statistical analysis of the onset of motor blockade, the onset of complete motor blockade and duration of motor blockade between group D vs C and group D vs F were statistically significant, whereas between group C vs F it was insignificant. The duration of analgesia was prolonged in Group D, C, F and was found to be statistically significant. Intergroup analysis of duration of analgesia between three different groups. The difference between group D vs C, between group D vs F, and between-group C vs F was statistically significant. The time of 1st rescue analgesia was prolonged in Group D, C, F and was statistically significant (p<0.05). Intergroup analysis of the time of 1st rescue analgesia between three different groups. The difference between group D vs C, between group D vs F, and between group C vs F were statistically significant. Conclusion: Dexmedetomidine, clonidine added to ropivacaine shortens the onset of sensory and motor blockade, prolongs the duration of the sensory blockade as compared to fentanyl. Dexmedetomidine shortens the onset of sensory and motor blockade much more than clonidine.

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“…[10]. Dexmedetomidine is an α2 adrenoceptor agonist highly special and selective, with α2: α1 selectivity binding ratio [11,12]. Our results in agreement with, Schnabel et al [13].…”

Section: Discussionsupporting

confidence: 90%

Comparative Study between the Effect of Perineural versus Intravascular Dexmedetomidine in Ultrasound-Guided Supraclavicular Brachial Plexus Block

Mohasseb¹,

Messbah

Amin

et al. 2020

JAMMR

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Background: Augmentation of postoperative analgesia with various adjuvants has become a standard in regional anesthesia. There are no studies about dexmedetomidine multiple approaches in supraclavicular brachial plexus block (BPB) was contrasted. We compare perineural dexmedetomidine and intravenous dexmedetomidine Bupivacaine as adjuvant in supraclavicular brachial plexus block. Materials and Methods: This prospective randomized controlled double-blind study was conducted on 120 patients with age between 20 and 60 years, both sexes, scheduled for elective upper limb surgery. Patients were randomly allocated into 3 groups, 40 patients in each received plain bupivacaine 0.5% (20 ml) in supraclavicular BPB; group I (Control group): add 1 mL normal saline perineural, group II: Bupivacaine with perineural dexmedetomidine (BDP) add 1 μg.kg-1dexmedetomidine perineurally. group III: Bupivacaine with intravenous dexmedetomidine (BDV) add 0.5 μg.kg-1 dexmedetomidine in 50 mL of normal saline administered as infusion over 10 min. Onset and duration of sensory and motor blocks, hemodynamic variables, adverse effects, and duration of analgesia were assessed. Results: Heart rate and mean arterial pressure was significantly decrease in group III &group II compared to group I were compared by ANOVA (F) test. onset of sensory &motor block was statistically significant shorter in group II compared to group I & III. Duration of sensory &motor block was statistically significant longer in group II compared to group I & III. there was statistically significant decrease VAS in group II were analysed using Kruskal-Wallis test between three groups. There was statistically significant increase RSS in group II & III. The first time of analgesic request was statistically significant prolonged in duration in group II. Conclusion: Perineural dexmedetomidine (1 µg/ kg) as an adjuvant to bupivacaine is significantly high thanIV dexmedetomidine (0.5 µg/ kg) and bupivacaine alone in supraclavicular BPB as regards to the onset and the duration of sensory block, so Increasingpostoperative analgesia.

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Comparative Study of the Efficacy of Dexmedetomidine and Fentanyl as Adjuvants to Ropivacaine in Ultrasound-Guided Supraclavicular Brachial Plexus Block

Cited by 16 publications

References 25 publications

Comparative Study between Fentanyl and Dexmedetomidine as Adjuvant to Ropivacaine in Brachial Plexus Block

Comparative Study between Fentanyl and Dexmedetomidine as Adjuvant to Ropivacaine in Brachial Plexus Block

Comparative Study for Anaesthetic Quality with the Addition of Clonidine, Fentanyl or Dexmedetomidine to 0.5℅ Ropivacaine in Supraclavicular Brachial Plexus Block at a Tertiary Hospital

Comparative Study between the Effect of Perineural versus Intravascular Dexmedetomidine in Ultrasound-Guided Supraclavicular Brachial Plexus Block

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