The Effect of Adding Dexmedetomidine as an Adjuvant to Lidocaine in Forearm Fracture Surgeries by Supraclavicular Block Procedure Under Ultrasound-Guided

Abstract

BackgroundTo improve the brachial plexus block (BPB) performance, different compounds have been used as adjuvants to local analgesics.ObjectivesThe aim of the present study was to investigate the effects of adding DEX to lidocaine on effectiveness of nerve block, and postoperative pain in forearm fracture surgery by supraclavicular BPB undergoing ultrasound-guided.MethodsThis was a double-blinded randomized clinical trial conducted on 72 patients with ASA classes I and II, which were candidates for forearm fracture surgery. In group A, patients received 3 mg/kg of lidocaine 2%. In group B, patients received 3 mg/kg of lidocaine 2% and DEX (1 µg/kg). The ultrasound-guided supraclavicular BPB was performed in all patients. The onset of sensory and motor blocks were evaluated with pin prick test and modified Bromage scale, respectively. The sensory and motor block moment was recorded as the onset of the block. The first analgesic request time, total consumed analgesic, adverse effect, and hemodynamic parameters of patients were recorded. A visual analog scale (VAS) was used for recording the severity of pain.ResultsThe two groups showed no significant difference in the demographic variables. The onset of sensory and motor block in the DEX groups was shorter. The duration of sensory and motor block, and analgesic request was significantly longer than the control groups. Total analgesic consumption 24 hours after surgery in the DEX groups was significantly lower. Moreover, hemodynamic status of patients in both groups was stable and no significant difference was observed between groups. This study showed that DEX, as an adjuvant to lidocaine, improve the characteristics of supraclavicular BPB and decrease the postoperative pain.

Comparison of the Post-Caesarean Analgesic Effect of Adding Dexmedetomidine to Paracetamol and Ketorolac: A Randomized Clinical Trial

“…In some studies, adding dexmedetomidine as an adjuvant to opioids or local anesthetics led to prolonged intraoperative analgesia, more postoperative pain relief, less nausea and vomiting, and fewer hemodynamic changes ( 26 - 28 ). In a study of pain management after caesarean section, adding dexmedetomidine to sufentanil decreased opioid consumption and increased patient satisfaction ( 29 ).…”

Comparison of Transforaminal Triamcinolone and Dexmedetomidine in Radicular Low-Back Pain

“…Adding dexmedetomidine as an adjuvant to paravertebral and supraclavicular blocks has caused better analgesia and lower postoperative analgesic consumption (27, 28). In a study, Bajwa et al administered dexmedetomidine, as an adjunct in epidural anesthesia, and reported its better effects compared to clonidine; it also improved patients’ comfort, cardiovascular parameters, and analgesia during the surgery and post-surgery (29).…”

Comparison of Sedation with Dexmedetomidine Alfentanil Versus Ketamine-Alfentanil in Patients Undergoing Closed Reduction of Nasal Fractures

“…The half-life of dexmedetomidine is 2.3 hours and its distribution half-life is less than 5 minutes; so, its clinical effects are very rapid ( 6 - 8 ). Also, it assists hemodynamic stability by its sympatholytic action, which has been used as a safe adjuvant during anesthesia in many clinical applications ( 9 - 12 ). Dexmedetomidine has been used as a sedative and hypnotic in procedures that do not need tracheal intubation.…”