Comparing the Efficacy of Dexmedetomidine When Used as an Adjuvant to Bupivacaine in Supraclavicular Brachial Plexus Blocks under Ultrasound-Guided

Abstract

Background: Ultrasound-guided for regional anesthesia offers many potential benefits in the emergency setting. Analgesia can be explicitly targeted to the region of pain and provide relief for many hours and decrease needing to the large volume of local anesthetic. The aim of the work: Comparing the efficacy of dexmedetomidine when used as an adjuvant to bupivacaine in supraclavicular brachial plexus blocks on the onset of sensory, motor blockade and postoperative analgesia. Patients and methods: This prospective, randomized, single-blind clinical study conducted on 60 patients underwent upper limb surgery done by ultrasound-guided supraclavicular brachial plexus block; these patients allocated into two equal groups: Group I (control) received 20 ccs (19 cc bupivacaine 0.5% + 1 cc saline), Group II received 20 cc (19 cc bupivacaine 0.5% + 1 cc volume of Dexmedetomidine 1 ug/kg). Results: Demographic data and surgical characteristics were comparable in both groups. The onset times for sensory and motor blocks were significantly shorter in Group II than Group I (P < 0.001), while the duration of blocks was considerably longer (P < 0.001) in Group II. Except for the first recordings (at 0, 5, and 10 min), heart rate levels in Group II were significantly lower (P < 0.001). MBP levels in Group II at 15, 30, 45, 60, 90 and 120 min were significantly lower than in Group I (P < 0.001). The duration of analgesia (DOA) was significantly longer in Group II than Group I (P < 0.001). As regards to the visual Analouge score, there is a highly significant difference at 6 hours, 8 hours and 10 hours in Group II than Group I. Conclusion: We recommend adding Dexmedetomidine to local anesthetics in peripheral nerve blocks to take advantage of the prolonged time of both sensory and motor blocks and prolonged postoperative analgesia.

Alpha2‐receptor agonists as adjuvants for brachial plexus nerve blocks—A systematic review with meta‐analyses

“…The summarized risk of bias was high in 26 trials , [12][13][14][15]22,31,33,38,43,46,50,53,56,57,59,60,63,70,72,73,75,77,81,87,96,104 unclear in 71 5,6,16−21,23−30,32,34−36,39−42,44,47−49,51,52,54,55,58,61,64−67,69,71,74,76,78−80, 82−86,88−95,97−101,103,105−111 trials and low in four trials (Figures 2-4). 37,45,62,68 All but four trials 30,41,61,78 included less than 100 patients.…”