BACKGROUND The aim of this study is to evaluate the effect of addition of dexmedetomidine to 0.25% bupivacaine in brachial plexus block. MATERIALS AND METHODS 80 consenting patients fulfilling the inclusion criteria were divided randomly into two groups using "slips in a box technique" of 40 each. Group D (study group)-30 mL of 0.25% bupivacaine with 0.5 mL (50 µg) dexmedetomidine. Group B (control group)-30 mL of 0.25% bupivacaine with 0.5 mL, 0.9% saline. Neural localisation was achieved using a nerve stimulator. All the patients received brachial plexus block through the supraclavicular approach by an experienced anaesthesiologist different from the one assessing the patient intra and postoperatively. Both were blinded to the treatment groups. Sensory block was assessed by pinprick test using 3-point scale. Motor blockade was assessed using Bromage 3-point score. Onset of sensory and motor block, duration of sensory and motor block, duration of analgesia and quality of block was noted. RESULTS There were no significant differences in demographic and haemodynamic data. Onset of sensory block was faster in Group D (12.33±1.64 mins.) compared to Group B (21.78±2.22 mins.). Onset of motor block was faster in Group D (9.38±1.55 mins.) compared to Group B (15.68±2.09 mins.). Duration of sensory block in Group D showed 508.50±33.25 mins. and Group B 219.38±24.42 mins. Duration of motor block in Group D showed 434.25±33.96 mins. and Group B 165.75±19.20 mins. Duration of analgesia in group D was 538.50±33.25 mins. compared to group B with 264.38±24.42 mins. Quality of block was better in Group D as compared to Group B. CONCLUSION Dexmedetomidine at the dose of 50 µg added to 0.25% bupivacaine in supraclavicular brachial plexus block in upper limb surgeries is highly effective in prolongation of motor and sensory analgesia and provides better postoperative analgesia without any potential side effects.
Hypotension during spinal anaesthesia is common and can cause significantmorbidity and mortality. Prior to spinal anaesthesia fluid administration isrecommended to reduce the incidence of hypotension and this is referred to aspreloading. Crystalloids and colloids are routinely tried as pre loading fluids but there is still considerable debate over their effectivenessas a pre loading. A comparative study was under taken to compare the hemodynamic changes of Ringers lactate v/s Hydroxy ethyl starch in 60 ASA grade-I &II patients posted for lower abdominal and lower limb elective surgeries and allocated into two groups. Each patient was administrated either Ringer's lactate solution at 10 ml/ Kg body or 6% Hydroxy ethyl starch at 10 ml/ Kg over a period of 20 minutes before spinal anaesthesia. Following spinal anaesthesia mean arterial pressure were recorded at regular intervals.We found that hydroxy ethyl starch is more effective than lactated Ringer's solution as a pre loading fluid in prevention of hypotension following spinal anesthesia. However, we also concluded that incidence of hypotension was only reduced but not completely eliminated in this study.
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