Dexmedetomidine as an adjuvant to ropivacaine prolongs peripheral nerve block: a volunteer study

Marhofer, Daniela; Kettner, Stephan C.; Marhofer, Peter; Pils, Sophie; Weber, M.; Zeitlinger, Markus

doi:10.1093/bja/aes400

Cited by 251 publications

(250 citation statements)

References 15 publications

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“…The difference was not found to be statistically significant. Similar findings were found in the studies conducted by Zhang Y and Marhofer et al [11,12] . Moreover they also found that the duration of sensory and motor blockade was more when Dexmedetomidine was used than in patients in whom only ropivacaine was used [13] .…”

Section: Discussionsupporting

confidence: 92%

Dexmedetomidine as an Adjuvant with Ropivacaine in Supraclavicular Brachial Plexus Block in Upper Limb Surgeries: A Case Control Study

Gupta¹

2017

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Section: Discussionsupporting

confidence: 92%

Dexmedetomidine as an Adjuvant with Ropivacaine in Supraclavicular Brachial Plexus Block in Upper Limb Surgeries: A Case Control Study

Gupta¹

2017

jmscr

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“…(16,18,23) Marhofer et al reported a profound prolongation of ulnar nerve block (UNB) of 60% with perineural dexmedetomidine when added to 0.75% ropivacaine whereas, systemic administration of 20 mcg dexmedetomidine resulted in a prolongation of only 10% during UNB with 0.75% ropivacaine. (24) It is unlikely that perineural administration of drug would produce significant systemic side effects, but a central effect that results from the systemic absorption of the drug cannot be excluded.…”

Section: Diagram 2: Trend In Mean Arterial Pressurementioning

confidence: 99%

Comparison of the Effects of Fentanyl and Dexmedetomidine in Supraclavicular Brachial Plexus Block Achieved With Ropivacaine

Cham¹,

Sangawar²,

Ramtani³

et al. 2015

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BACKGROUND & OBJECTIVES:Supraclavicular block of brachial plexus provides complete and reliable anaesthesia for upper limb surgeries. Ropivacaine, is an affective local anaesthetic in for brachial plexus anaesthesia. It is a potent blocker of Aδ and C fibres, rendering good sensory effect but less motor blockade. We evaluated the anaesthetic quality and length of analgesia with the addition of either fentanyl or dexmedetomidine to ropivacaine for Supraclavicular brachial plexus block. METHODS: In a prospective clinical trial, 90 patients were randomly allocated to either receive 30 ml ropivacaine 0.5% (Group R), 30 ml ropivacaine 0.5% with fentanyl 50 mcg (Group RF) or 30 ml ropivacaine 0.5% with dexmedetomedine 50 mcg (Group RD) in Supraclavicular brachial plexus. The characteristics for anaesthesia and analgesia were assessed for the three groups. OBSERVATIONS: Demographic profile was comparable in the groups. The onset of analgesia and time to complete analgesia was enhanced in Group RD and Group RF compared to Group R. Prolongation of sensory blockade and motor blockade with extended duration of postoperative analgesia was observed in Group RD and Group RF compared to Group R. There were minimum haemodynamic disturbances and side-effects in any group except for Grade 3 sedation score which was frequently noted in patients receiving dexmedetomidine as adjunct. RESULTS: Compared to the use of ropivacaine 0.5%, 30 ml alone for supraclavicular brachial plexus block, the addition of 50 mcg fentanyl or 50 mcg dexmedetomidine to ropivacaine enhanced onset of block and also increased duration of surgical anaesthesia with prolongation of post-operative analgesia. Furthermore blockade characteristics improved better with addition of dexmedetomodine than fentanyl without increasing incidence of unwanted side-effects.

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“…The prospective, double-blinded, controlled volunteer study conducted by Marhofer et al using dexmedetomidine (20µg) as additive with (0.75%) ropivacaine in ultrasound guided ulnar nerve block revealed, 60% prolongation of sensory and motor block with perineural dexmedetomidine . 7 Kathuria et al in their study obtained similar results with 50µg dexmedetomidine in 30ml of 0.5% ropivacaine for SBPB. 8 Swami et al concluded that dexmedetomidine (1μg/kg) when added to local anaesthetic (bupivacaine 0.25%) in SBPB increased the duration of sensory and motor block and also the duration of analgesia.…”

Section: Discussionmentioning

confidence: 52%

“…Similar results were also obtained by Marhofer et al with perineural dexmedetomidine and Kaygusuzet al with dexmedetomidine in axillary brachial plexus block. 7,14 However Das et al noticed that when dexmedetomidine was added to 0.5% ropivacaine in supraclavicular brachial plexus block, there was no clinically significant difference in the onset of block. 15 Similarly Rancourt et al evaluated the effect of dexmedetomidine (1μg/kg) when added to 10ml of 0.5% ropivacaine for posterior tibial nerve block.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound guided supraclavicular brachial plexus block using plain ropivacaine and ropivacaine with adjuvants

Mathew

Prasad

Krishna

et al. 2017

Sri Lankan J Anaesthesiol

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Context: Ultrasound (US) guided supraclavicular brachial plexus block (SBPB) provides predictable dense blockade. Inclusion of additives to local anaesthetics alters the quality of blockade. Aim:To assess the block characteristics of ropivacaine alone and with additives in US guided SBPB. Materials and Methods:Prospective, double blinded randomized controlled trial. Sixty patients undergoing elective upper limb surgeries under SBPB were randomly allocated to one of 3 groups: Group RR (who received 30ml of 0.5% ropivacaine), Group RD (30ml of 0.5% ropivacaine with 1 µ g/kg of dexmedetomidine) and Group RM (30ml of 0.5% ropivacaine with 50µ g/kg of midazolam). After administration of block with above drugs, the block characteristics were assessed every 3mins till onset of complete blockade, every 30mins for 6hrs, then hourly for 24hrs. Apart from sensory and motor blockade, sedation score was also assessed. Results:The duration of blockade (min) was significantly longer in Group RD (907 ± 205) compared to Group RR (597 ± 101) and Group RM (605 ± 188). There was no difference among the groups with respect to onset of sensory and motor blockade. The sedation scores were significantly higher in Group RD (median = 3) and Group RM (median = 2). Conclusion:Addition of dexmedetomidine to ropivacaine in ultrasound guided supraclavicular brachial plexus block prolongs both sensory and motor blockade. Both dexmedetomidine and midazolam when added to ropivacaine produce significant sedation.

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Dexmedetomidine as an adjuvant to ropivacaine prolongs peripheral nerve block: a volunteer study

Abstract: A profound prolongation of UNB of ∼60% was detected with perineural dexmedetomidine when added to 0.75% ropivacaine. The systemic administration of 20 µg dexmedetomidine resulted in a prolongation of ∼10% during UNB with 0.75% ropivacaine. Eudra-CT No.: 2012-000030-19.

Cited by 251 publications

References 15 publications

Dexmedetomidine as an Adjuvant with Ropivacaine in Supraclavicular Brachial Plexus Block in Upper Limb Surgeries: A Case Control Study

Dexmedetomidine as an Adjuvant with Ropivacaine in Supraclavicular Brachial Plexus Block in Upper Limb Surgeries: A Case Control Study

Comparison of the Effects of Fentanyl and Dexmedetomidine in Supraclavicular Brachial Plexus Block Achieved With Ropivacaine

Ultrasound guided supraclavicular brachial plexus block using plain ropivacaine and ropivacaine with adjuvants

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