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.
Background: Spinal anaesthesia remains one of the basic techniques in the arsenal of modern anaesthesiology despite the waxing and waning of its popularity over last 100 years since its introduction into clinical practice.It avoids biochemical and metabolic changes consequent to the stress of general anesthesia for surgery as well as provides near optimal conditions for surgery. In present study, we tried to study effectiveness of intrathecal 0.5% heavy bupivacaine alone with Dexmedetomidine as an adjuvant to intrathecal 0.5% heavy bupivacaine for lower limb and lower abdominal surgeries.Methods: The present study was conducted in the department of anaesthesiology from December 2011 to September 2013.This study was a prospective, randomised controlled, single blind, study conducted in 100 patients of ASA grade I and II undergoing elective surgeries under spinal anaesthesia. The patients were divided randomly into two groups, containing 50 patients in each group. Dosages of drugs selected are divided as Group B: Patients received 3 ml of 0.5% hyperbaric bupivacaine (15mg) and Group BD: Patients received 3 ml of 0.5% hyperbaric bupivacaine (15mg) plus 10 µg Dexmedetomidine. Spinal block characteristics, Mean arterial pressure, Mean pulse rate, sedation and side effects were studied during intra-operative and postoperative period.Results: It was found from present study that in Dexmedetomidine group time to reach T10 sensory blockade and complete motor blockade was earlier and a higher level of sensory blockade compared to control group achieved. Duration of sensory, motor blockade and duration of analgesia was significantly prolonged in the Dexmedetomidine group compared to the control group. Hemodynamic parameters were preserved both intra-operatively and postoperatively. However there were a small percentage of patients who developed hypotension and bradycardia which were easily managed without any untoward effect. Hence Dexmedetomidine is a better neuraxial adjuvant for providing early onset of sensory and motor blockade, prolonged sensory blockade and post operative analgesia and adequate sedation.Conclusions: Intrathecal low dose Dexmedetomidine in a dose of 10µg along with 0.5% hyperbaric bupivacaine is an addition into anaesthesiologist's armamentarium for spinal anaesthesia in patients undergoing elective lower abdominal and lower limb surgeries.
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