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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 signicant (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 signicant (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 signicant (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 signicant. 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 signicant.
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 signicant (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 signicant (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 signicant (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 signicant. 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 signicant.
Brachial plexus block provide a useful alternative to general anaesthesia for upper limb surgeries.Ropivacaine is one of the most frequently used local anaesthetic which has longer duration of action but has drawbacks of delayed onset and patchy analgesia. Dexamethasone is very potent glucocorticoid with very good anti-inflammatory and analgesic activity. A prospective, randomised double blinded study was undertaken in patients posted for upper limb surgeries under supraclavicular block. 80 patients with ASA class I and II were randomly grouped into two groups. Group R received 28ml ropivacaine 0.5% and 2ml normal saline and Group RD received combination of 28ml ropivacaine 0.5% and 2ml/8mg dexamethasone. 30ml solution is used for a single shot blockade of supraclavicular brachial plexus. Combination of ropivacaine 0.5% and dexamethasone 8mg has significantly hasten onset and duration of sensory and motor blockade and prolonged duration of analgesia.
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