Dexmedetomidine vs Dexamethasone as an Adjuvant to 0.5% Ropivacaine in Ultrasound Guided Supraclavicular Brachial Plexus Block

Abstract

Background And Aims: Both dexmedetomidine and dexamethasone have individually been shown to be benecial as an adjuvant to ropivacaine. We compared the efcacy of combination of ropivacaine with dexmedetomidine and ropivacaine with dexamethasone in ultrasound guided supraclavicular brachial plexus (SCBP) block. Material And Methods: In this prospective randomised double blind controlled trial, 60 ASA physical status I/II patients undergoing elective upper limb surgery under ultrasound guided SCBP block with 30 ml of 0.5% ropivacaine were randomised into three groups. Group 1 (n = 20) received 1 μg/kg of dexmedetomidine, and group 2 (n = 20) received 8 mg of dexamethasone in addition to ropivacaine, while group 3 (n = 20) received only ropivacaine. The primary outcomes studied were onset and duration of sensory and motor block. Secondary outcomes included duration of analgesia, total analgesic consumption in 24 h postoperatively and quality of block. ANOVA and Chi-square test were used to compare results on continuous measurements and categorical measurements, respectively. Results: Onset of sensory and motor block was faster in group 1 (13.5 ± 4.1 and 17.0 ± 4.1 min) and group 2 (15.6 ± 3.6 and 18.5 ± 3.7 min) as compared to group 3 (20.1 ± 5.3 and 24.9 ± 5.6 min; P < 0.001). Block duration was signicantly longer in group 1 and group 2 than in group 3. Duration of analgesia was prolonged in group 1 and 2 (1218.0 ± 224.6 and 1128.0 ± 207.5 min, respectively) as compared to group 3 (768.0 ± 273.7 min; P < 0.001). Twenty four hours analgesic consumption postoperatively was reduced in the two study groups. Conclusion: Both dexmedetomidine and dexamethasone when used as adjuvants to ropivacaine for SCBP block, block onset time, and prolong' block duration