Comparative study on the clinical profile of different doses of dexmedetomidine with levobupivacaine in supraclavicular brachial plexus block

Balakrishnan, S; Kunikkakath, Shamjith; Jacob, Kevin Koshy; Shenoy, Mangesh

doi:10.5958/2394-4994.2016.00073.1

Cited by 7 publications

(24 citation statements)

References 14 publications

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“…The onset time of sensory block (9.36±1.114 mins in group Rd Vs 8.32 ± 0.945mins in group RD) were not significantly different between two groups (p-value > 0.05).The onset time of motor block (14.40 ±1.528mins in group Rd Vs 12.40 ± 1.21 mins in group RD) were not significantly different between two groups (pvalue > 0.05). These findings correlated with the studies done by Thakur et al, 13 Balkrishnan et al, 14 Joseph et al 15 In our study, the duration of sensory block (596.20 ± 76.859 mins in group Rd Vs 730.80 ± 65.187 mins in group RD) were not significantly longer in group RD than group Rd (pvalue > 0.05). The duration of motor block (541.20±81.564 mins in group Rd Vs 659.80±93.607 mins in group RD) was not significantly longer in group RD than group Rd (pvalue > 0.05).…”

Section: Discussionsupporting

confidence: 93%

“…The duration of analgesia (626.00±70.475 mins in group Rd Vs 754.00±60.139 mins in group RD) was significantly longer in group RD than group Rd (p-value> 0.05). These findings correlated with the studies done by Thakur et al, 13 Balkrishnan et al, 14 Joseph et al 15 Dexmedetomidine added as an adjuvant shortens the onset of sensory and motor block as well as prolongs the duration of sensory and motor block and duration of analgesia. [13][14][15][16][17][18] But the ideal dose of dexmedetomidine as an adjuvant is not defined.…”

Section: Discussionsupporting

confidence: 88%

“…These findings correlated with the studies done by Thakur et al, 13 Balkrishnan et al, 14 Joseph et al 15 Dexmedetomidine added as an adjuvant shortens the onset of sensory and motor block as well as prolongs the duration of sensory and motor block and duration of analgesia. [13][14][15][16][17][18] But the ideal dose of dexmedetomidine as an adjuvant is not defined. Here, we compared 2mcg/kg and 1mcg/ kg of dexmedetomidine added to ropivaciane in terms of onset of sensory and motor block as well as duration of sensory and motor block and duration of analgesia.…”

Section: Discussionsupporting

confidence: 88%

“…We find no statistically different results in between two groups. Thakur et al, 13 Balkrishnan et al, 14 Joseph et al, 15 also did not find any difference between two doses of dexmedetomidine as an adjuvant to local anesthetics. Sedation score were higher in RD group than Rd group but were not significantly different between two groups (p-value> 0.05).…”

Section: Discussionmentioning

confidence: 94%

“…Complications developed with higher doses of dexmedetomidine. [13][14][15][16][17] So, in comparison to 2mcg/kg dexmedetomidine, 1mcg/kg would be ideal dose as adjuvant to local anesthetics to shorten onset of block, prolong duration of block and analgesia as well as decrease the complications related to dexmedetomidine.…”

Section: Discussionmentioning

confidence: 99%

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A Comparative Study Between Two Different Doses of Dexmedetomidine Combined with Ropivacaine in Ultrasound Guided Supraclavicular Brachial Plexus Block

Singh

Shakya²,

Ghimire³

et al. 2018

J Coll Med Sci-Nepal

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Background: Though, various studies have been conducted to show the efficacy of dexmedetomidine as an adjuvant to brachial plexus block, there is no clear consensus for its optimal dose. We compared 2 different doses of dexmedetomidine (1mcg/kg Vs 2mcg/kg) with ropivaciane in USG guided brachial plexus block for the quality of anesthesia and analgesia. Materials and Methods: Fifty patients (18-50years, 50-60kgs), ASA PS I and II undergoing surgery of upper limb were enrolled in this prospective, double blind, randomized control trial. Group Rd received 19ml of 0.5% Ropivaciane with 1mcg/kg of dexmedetomidine (total 20ml), and Group RD received 19ml of 0.5% Ropivacaine with 2mcg/kg of dexmedetomidine (total 20ml). Onset and duration of sensory and motor block, duration of analgesia, sedation score, hemodyanamic changes were compared. We also monitored for various un towards effects. Results: The onset time of sensory and motor block (9.36±1.114 mins and 14.40 ± 1.528 mins in group Rd vs 8.32 ±0.945 mins and 12.40 ± 1.21 mins in group RD) were not significantly different between two groups (p-value > 0.05).The duration of sensory and motor block (596.20 ± 76.859 mins and 541.20±81.564 mins in group Rd vs 730.80 + 65.187 mins and 659.80±93.607 mins in group RD) were not significantly longer in group RD than group Rd (p-value > 0.05). The duration of analgesia (626.00±70.475 mins in group Rd vs 754.00±60.139 mins in group RD) were not significantly longer in group RD than group Rd (p-value > 0.05). Hemodynamic parameters were also comparable between two groups (p-value >0.05) but 3 patients in RD group (2mcg/kg) developed bradycardia and required treatment with atropine whereas in Rd group (1mcg/kg) none developed bradycardia. Conclusions: There is no significant difference in the onset and duration of block between the two groups. However, higher dose of dexmedetomidine is associated bradycardia. Hence, in comparision with 2mcg/kg, 1mcg/kg of dexmedetomidine is better adjuvant to 0.5% ropivaciane in terms of safety and effectiveness.Keywords: dexmedetomidine; ropivacaine; supraclavicular brachial plexus block.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

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A Comparative Study Between Two Different Doses of Dexmedetomidine Combined with Ropivacaine in Ultrasound Guided Supraclavicular Brachial Plexus Block

Singh

Shakya²,

Ghimire³

et al. 2018

J Coll Med Sci-Nepal

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Perineural and intravenous dexamethasone and dexmedetomidine: network meta‐analysis of adjunctive effects on supraclavicular brachial plexus block

et al. 2020

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Both perineural and intravenous dexamethasone and dexmedetomidine are used as local anaesthetic adjuncts to enhance peripheral nerve block characteristics. However, the effects of dexamethasone and dexmedetomidine based on their administration routes have not been directly compared, and the relative extent to which each adjunct prolongs sensory blockade remains unclear. This network meta-analysis sought to compare and rank the effects of perineural and intravenous dexamethasone and dexmedetomidine as supraclavicular block adjuncts. We sought randomised trials investigating the effects of adding perineural and intravenous dexamethasone or dexmedetomidine to long-acting local anaesthetics on supraclavicular block characteristics, including time to block onset and durations of sensory, motor and analgesic blockade. Data were compared and ranked according to relative effectiveness for each outcome. Our primary outcome was sensory block duration, with a 2-h difference considered clinically important. We performed a frequentist analysis, using the GRADE framework to appraise evidence. One-hundred trials (5728 patients) were included. Expressed as mean (95%CI), the control group (local anaesthetic alone) had a duration of sensory block of 401 (366-435) min, motor block duration of 369 (330-408) min and analgesic duration of 435 (386-483) min. Compared with control, sensory block was prolonged most by intravenous dexamethasone [mean difference (95%CI) 477 (160-795) min], followed by perineural dexamethasone [411 (343-480) min] and perineural dexmedetomidine [284 (235-333) min]. Motor block was prolonged most by perineural dexamethasone [mean difference (95%CI) 294 (236-352) min], followed by intravenous dexamethasone [289 (129-448)min] and perineural dexmedetomidine [258 (212-304)min]. Analgesic duration was prolonged most by perineural dexamethasone [mean difference (95%CI) 518 (448-589) min], followed by intravenous dexamethasone [478 (277-679) min] and perineural dexmedetomidine [318 (266-371) min]. Intravenous dexmedetomidine did not prolong sensory, motor or analgesic block durations. No major network inconsistencies were found. The quality of evidence for intravenous dexamethasone, perineural dexamethasone and perineural dexmedetomidine for prolongation of supraclavicular sensory block duration was 'low', 'very low' and 'low', respectively. Regardless of route, dexamethasone as an adjunct prolonged the durations of sensory and analgesic blockade to a greater extent than dexmedetomidine. Differences in block characteristics between perineural and intravenous dexamethasone were not clinically important. Intravenous dexmedetomidine did not affect block characteristics.

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Comparison of the efficacy of two doses of dexmedetomidine as an adjunct to levobupivacaine in infraclavicular brachial plexus block: prospective double-blinded randomized controlled trial

et al. 2022

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Background This prospective, double-blind, randomized, controlled trial compared the efficacy of two dexmedetomidine doses (50 and 100-μg) combined with levobupivacaine on sensory block duration in infraclavicular brachial plexus block. We hypothesized that perineural dexmedetomidine would extend sensory block duration dose-dependently. Methods The study included 60 patients aged 20 to 60 years of both sex with an ASA I/II undergoing forearm and hand surgery. The patients were randomly assigned into three equal groups (n = 20) for ultrasound-guided infraclavicular brachial plexus block. The L group received 35-mL 0.5% levobupivacaine plus normal saline, the LD50 group received 35-mL 0.5% levobupivacaine plus 50-μg dexmedetomidine, and the LD100 group received 35-mL 0.5% levobupivacaine plus 100-μg dexmedetomidine. Patients were investigated for onset and duration of sensory blockade, time to first postoperative rescue analgesia, and the total 24-h postoperative morphine requirement. Results The LD100 group had a longer sensory block duration (15.55 ± 1.1 h; 95% confidence interval (CI), 15.04–16.06) than the LD50 group (12.8 ± 1.2 h; 95% CI, 12.24–13.36 h) (p < 0.001) or the L group (9.95 ± 1.05 h; 95% CI, 9.46–10.44 h) (p < 0.001). The LD100 group took longer to request postoperative rescue analgesia and required fewer postoperative morphine doses than the LD50 and L groups (P < 0.001). Conclusions Sensory block duration was longer with perineural 100-μg dexmedetomidine as an adjunct to levobupivacaine than with 50-μg dexmedetomidine. Trial registration This study was approved by the Ethics Committee of Aswan University Hospital (approval number: aswu/125/4/17) (date of registration: 04/04/2017). Furthermore, the trial was retrospectively registered at ClinicalTrial.gov (NCT04729868) with a verification date of January 2021.

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Comparative study on the clinical profile of different doses of dexmedetomidine with levobupivacaine in supraclavicular brachial plexus block

Cited by 7 publications

References 14 publications

A Comparative Study Between Two Different Doses of Dexmedetomidine Combined with Ropivacaine in Ultrasound Guided Supraclavicular Brachial Plexus Block

A Comparative Study Between Two Different Doses of Dexmedetomidine Combined with Ropivacaine in Ultrasound Guided Supraclavicular Brachial Plexus Block

Perineural and intravenous dexamethasone and dexmedetomidine: network meta‐analysis of adjunctive effects on supraclavicular brachial plexus block

Comparison of the efficacy of two doses of dexmedetomidine as an adjunct to levobupivacaine in infraclavicular brachial plexus block: prospective double-blinded randomized controlled trial

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