Vol. 5, Issue 2 (2019)
A comparative study of dexmedetomidine and fentanyl as an adjuvant with 0.5% ropivacaine in infraclavicular brachial plexus block via coracoid approach
Author(s): Parmod Kumar, Davinder Chawla, Charu Sharma
Abstract: Background: Infraclavicular brachial plexus block provide effective and reliable analgesia for upper limb surgery. Adjuvants to local anaesthetic may enhance the duration and quality of analgesia. Material and Methods: After informed consent 60 patients, aged 18 to 65 years, ASA I and II, of either sex scheduled to undergo elective elbow, forearm and hand surgery under infraclavicular brachial plexus block at Government Medical College Patiala were randomly divided into two groups of 30 patients each. Group D received 30 ml 0.5% ropivacaine + 50 µg dexmedetomidine. Group F received 30 ml 0.5% ropivacaine + 50 µg fentanyl. Patients were observed for onset and duration of sensory and motor blockade, haemodynamic changes, and duration of analgesia, postoperative pain, and adverse effects Result: Demographic profile was comparable in the groups. The time of onset and time to complete sensory and motor blockade was early in Group F compared to Group D. Duration of sensory and motor blockade and postoperative analgesia was prolonged in Group D as compared to Group F. In Group D, decrease in mean HR and Grade 3or 4 modified ram say sedation score was observed. Conclusion: Dexmedetomidine provides prolonged analgesia and more-dense block with less requirement of rescue analgesics as compared to fentanyl. The low heart rate and achievement of sedation score of 3 or 4 is beneficial for haemodynamic stability and better quality of block.