2. Head of Department of Anaesthesiology, P.D.U. Medical College Rajkot, Gurukrupa 4A Shardanagar Society, University road, Rajkot.
3. Associate professsor Department of Anaesthesiology, P.D.U. Medical College Rajkot, F-201, SadguruVatika, Maruti Nagar 2, Airport road, Rajkot.
4. 3rd Year Resident Doctor, P.D.U. Medical College Rajkot, 4 N Jamal’s Plazzo, 47medavakkam main road,Keelkattalai,Chennai-600117, India.
Context: To provide intraoperative and postoperative analgesia for upper limb surgeries the infraclavicular brachial plexus block (ICB) is very safe and reliable approach. α2 agonists are added to local anaesthetic agents as an adjuvant to extend the duration of nerve blocks.
Aims: Aim was to compare the efficacy of infraclavicular block with dexmedetomidine added to bupivacaine, xylocaine adrenaline mixture and bupivacaine, xylocaine adrenaline mixturealone with respect to duration of motor, sensory blockade and duration of analgesia in form of VAS (visual analogue scale).
Objective was to note the time for first rescue analgesic,sedation level of the patients and hemodynamic parameters.
Methods and material: A prospective randomized controlled study including 50 patients who were given vertical ICB using Peripheral nerve locator were divided into two equal groups. Control group (Group L) received Inj. Bupivacaine (0.5%) 15 ml+xylocaine adrenaline (1:200000) (2%) 10 ml+normal saline 10ml. Dexmedetomidine group (Group LD) received Inj. Bupivacaine (0.5%) 15 ml+xylocaine adrenaline (1:200000) (2%) 10 ml+normal saline 8 ml+dexmedetomidine 1.5 microgram/kg making total 35ml.
For data analysis t test was applied.
Results: The onset of sensory and motor blockade were faster in LD group than L group (p<0.05). The duration of sensory and motor blockade and duration of analgesia were significantly longer in LD group (p<0.001). Patients in group LD were sedated with no adverse effects except bradycardia in three patients.
Conclusions: Dexmedetomidine as an adjuvant to local anaesthetic agents in infraclavicular block hastens the onset and prolongs the duration of sensory and motor blockade along with duration of postoperative analgesia.
Keywords: Infraclavicular brachial plexus block, dexmedetomidine, bupivacaine, lignocaine, postoperative analgesia