Effect of added alpha 2 agonists with local anaesthetic in infraclavicular brachial plexus block: A comparative study between dexmedetomidine and clonidine

Sreeja, R; Mathew, Abbey; Velayuden, Madhu

doi:10.4103/aer.aer_54_21

Cited by 4 publications

(4 citation statements)

References 7 publications

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“…12 Still in another study, quicker onset of motor block durations, longer sensory, and more prolonged analgesia were observed when bupivacaine was used along with 1 µg/kg dexmedetomidine compared to bupivacaine alone for the supraclavicular block. 13 Our results corroborate with the existing research, where we used 20 mL of levobupivacaine (0.25%) (n=30) in group L patients and 20 mL of levobupivacaine (0.25%) along with 1 µg/kg dexmedetomidine adjuvant in Group LD patients. We, therefore, found that dexmedetomidine enhances the anesthetic efficacy of levobupivacaine.…”

Section: Discussionsupporting

confidence: 91%

A comparative study of 0.25% levobupivacaine and 0.25% levobupivacaine with dexmedetomidine in ultrasound-guided transverse abdominis plane block for post-operative analgesia in infraumbilical surgeries

Dhanashree PJ,

Bammidi Muralikrishna,

Venkata Krishna Gollapalli

et al. 2023

Asian J Med Sci

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Background: Transversus abdominis plane (TAP) block delivers excellent analgesia with few side effects. Previous research suggests that the efficacy and duration of the block can be increased by adding adjuvants such as dexmedetomidine to the local anesthetics. Aims and Objectives: To compare the post-operative analgesic effectiveness of 0.25% levobupivacaine and 0.25% levobupivacaine with dexmedetomidine 1 μg/kg in US-guided TAP block in infraumbilical surgery patients. Materials and Methods: Ultrasound-guided TAP block was given to sixty patients. Patients consented for infraumbilical surgery, and patients were randomly assigned to two groups: Group L received 20 mL of 0.25% levobupivacaine alone and Group LD received 20 mL of 0.25% levobupivacaine with dexmedetomidine 1 μg/kg. The efficacy of analgesia was measured in terms of degree and duration of analgesia; the post-operative pain was evaluated using a visual analog scale (VAS). The Chi-square test and Student’s t-test were used for statistical analysis. Results: Result shows that there is no statistically significant difference in gender, age group, weight, height, BMI, and type of surgery between groups, with a P=0.40, 0.83, 0.37, 0.59, and 0.93, respectively. In addition, there is no statistically significant difference in the duration of surgery between the groups (P=0.63). However, it was observed statistically significant differences in the onset of analgesia requirement, duration of effect of analgesia, and the total anesthesia consumption between the experimental groups with a P=0.001, 0.001, and 0.001, respectively. No significant difference in VAS was observed initially but was significant in later hours. Conclusion: Adding dexmedetomidine to 0.25% levobupivacaine enhanced the efficacy of the block and duration of post-operative analgesia compared to 0.25% levobupivacaine alone.

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Section: Discussionsupporting

confidence: 91%

A comparative study of 0.25% levobupivacaine and 0.25% levobupivacaine with dexmedetomidine in ultrasound-guided transverse abdominis plane block for post-operative analgesia in infraumbilical surgeries

Dhanashree PJ,

Bammidi Muralikrishna,

Venkata Krishna Gollapalli

et al. 2023

Asian J Med Sci

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“…It also enhanced the quality of the block as compared with clonidine [ 132 ] Dexmedetomidine vs clonidine Compare dexmedetomidine or clonidine could improve the analgesic profile of levobupivacaine to the same extent during TAPB Adding dexmedetomidine to levobupivacaine can extend the time of analgesia and reduce the use of postoperative backup analgesics with minimal sedation effects when used in TAPB in pediatrics undergoing laparoscopic orchiopexy. Clonidine can be used as an alternative adjuvant to local anesthetics with good postoperative analgesic profiles [ 90 ] Dexmedetomidine vs clonidine Compare dexmedetomidine and clonidine added to bupivacaine in infraclavicular BPB Dexmedetomidine provides a quicker and prolonged analgesic action without major adverse effects [ 133 ] Dexmedetomidine vs clonidine Review the efficacy and safety of dexmedetomidine and clonidine as perineural or systemic adjuvants for BPB Alpha2-receptor agonists used as adjuvants for BPB lead to a prolonged duration of analgesia, with dexmedetomidine as the most efficient. Alpha2-receptor agonists were associated with an increased risk of cardiovascular adverse events [ 54 ] Dexmedetomidine vs nalbuphine Compare dexmedetomidine and nalbuphine in BPB Compared with dexmedetomidine, nalbuphine had significantly shorter sensory and motor block onset time, longer block duration, less analgesic need, and fewer side effects [ 135 ] Dexmedetomidine vs nalbuphine Compare nalbuphine and dexmedetomidine for ESPB in VATS Nalbuphine and dexmedetomidine are comparable in terms of the associated analgesia, sensory block duration, need for rescue analgesia, and incidence of chronic pain in patients after VATS in ESPB [ 136 ] Dexmedetomidine vs nalbuphine Compare dexmedetomidine and nalbuphine in TVPB in breast cancer surgeries Adding nalbuphine to TPVB improved the block’s quality and decreased postoperative analgesic requirements.…”

Section: Comparative Studies Of Dexmedetomidine With Other Drugsmentioning

confidence: 99%

“…Compared to 1 μg/kg clonidine, 1 μg/kg dexmedetomidine provides a quicker and prolonged analgesic action without major adverse effects. 133 More systematic meta-analysis also identified that α 2 -adrenergic receptor agonists used as adjustments for BPBs lead to a prolonged analysis period, with dexmedetomidine as the most effective. However, α 2 -adrenergic receptor agonists were associated with an increased risk of cardiovascular adverse events.…”

Section: Comparative Studies Of Dexmedetomidine With Other Drugsmentioning

confidence: 99%

Dexmedetomidine as an Adjuvant in Peripheral Nerve Block

Chen¹,

Liu²,

Feng³

et al. 2023

DDDT

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Peripheral nerve block technology is important to balanced anesthesia technology. It can effectively reduce opioid usage. It is the key to enhance clinical rehabilitation as an important part of the multimodal analgesia scheme. The emergence of ultrasound technology has accelerated peripheral nerve block technology development. It can directly observe the nerve shape, surrounding tissue, and diffusion path of drugs. It can also reduce the dosage of local anesthetics by improving positioning accuracy while enhancing the block’s efficacy. Dexmedetomidine is a highly selective drug α 2 -adrenergic receptor agonist. Dexmedetomidine has the characteristics of sedation, analgesia, anti-anxiety, inhibition of sympathetic activity, mild respiratory inhibition, and stable hemodynamics. Numerous studies have revealed that dexmedetomidine in peripheral nerve blocks can shorten the onset time of anesthesia and prolong the time of sensory and motor nerve blocks. Although dexmedetomidine was approved by the European Drug Administration for sedation and analgesia in 2017, it has not yet been approved by the US Food and Drug Administration (FDA). It is used as a non-label drug as an adjuvant. Therefore, the risk-benefit ratio must be evaluated when using these drugs as adjuvants. This review explains the pharmacology and mechanism of dexmedetomidine, the effect of dexmedetomidine on various peripheral nerve block as an adjuvant, and compare it with other types of adjuvants. We summarized and reviewed the application progress of dexmedetomidine as an adjuvant in nerve block and look forward to its future research direction.

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“…Dexmedetomidine [3,4,[11][12][13] is a highly selective alpha-2 receptor agonist that can stimulate alpha-2 receptors located in the locus coeruleus and spinal cord. It exerts both sedative and analgesic effects.…”

Section: Discussionmentioning

confidence: 99%

Sedative Effects of Dexmedetomidine in Combination with Propofol in Patients with Atrial Fibrillation Undergoing Electrical Cardioversion following Catheter Ablation

Liu,

Peng,

et al. 2024

Preprint

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Background To observe the safety and effectiveness of sedation in patients with atrial fibrillation (AF) undergoing electrical cardioversion following catheter ablation using a combination of propofol and dexmedetomidine (P-D group) versus propofol alone (P group). Methods A total of 120 AF patients undergoing electrical cardioversion post-catheter ablation were enrolled from October 2020 to August 2022. They were randomly assigned to either the observation group (P-D group) or the control group (P group), with 60 patients in each group. Vital signs, adverse events, analgesic effects, and awakening time were assessed at different stages (T0-T4) in both groups. Results In P-D group, HR was lower than T0 in T1-4, the MAP and SpO2 began to decreased in T2-3.In P group, SpO2, HR and MAP in T2-4 were all inferior to baseline period of T0. Whereas, in P-D group, the descend range of MAP and SpO2 of T2, and the SpO2 of T3 were distinctly less than the P group. The adverse events including respiratory depression and bradycardia in P-D group were inferior to the P group (16.7% vs 40% P = 0.045; 13.3% vs 3.3%; P = 0.35). The satisfaction of analgesia in P-D group was apparently prominent than P group (93.3% vs 73.3%;P < 0.05). Conclusion In AF patients requiring electrical cardioversion, the combination of propofol and dexmedetomidine demonstrates good sedative and analgesic effects, significantly reducing the propofol dosage and lowering the incidence of clinical adverse events, thereby enhancing medication safety.

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Effect of added alpha 2 agonists with local anaesthetic in infraclavicular brachial plexus block: A comparative study between dexmedetomidine and clonidine

Cited by 4 publications

References 7 publications

A comparative study of 0.25% levobupivacaine and 0.25% levobupivacaine with dexmedetomidine in ultrasound-guided transverse abdominis plane block for post-operative analgesia in infraumbilical surgeries

A comparative study of 0.25% levobupivacaine and 0.25% levobupivacaine with dexmedetomidine in ultrasound-guided transverse abdominis plane block for post-operative analgesia in infraumbilical surgeries

Dexmedetomidine as an Adjuvant in Peripheral Nerve Block

Sedative Effects of Dexmedetomidine in Combination with Propofol in Patients with Atrial Fibrillation Undergoing Electrical Cardioversion following Catheter Ablation

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