To compare the efficacy of postoperative analgesia between clonidine and dexmedetomidine as adjuvants with 0.5% ropivacaine by ultrasound-guided supraclavicular brachial plexus block for upper limb surgeries: A prospective, double-blind, randomized study

Kumari, Preeti; Singh, Raj; Saurabh, Kumar; Pal, Shilpi; Ram, Ganesh Kumar; Anand, Rakesh Kumar

doi:10.4103/aer.aer_57_21

Cited by 5 publications

(4 citation statements)

References 24 publications

(30 reference statements)

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“…The combination of ropivacaine and dexmedetomidine showed promise in this trial, especially for orthopaedic surgeries. 16 The purpose of this study is to examine how well magnesium sulphate works with ropivacaine to prevent post-operative analgesia following upper limb procedures. A thorough research approach to address the critical problem of postoperative pain management in patients undergoing upper limb procedures is outlined in the study protocol that is being presented.…”

Section: Discussionmentioning

confidence: 99%

To compare the efficacy of ropivacaine alone versus ropivacaine with magnesium sulphate for postoperative analgesia in peripheral nerve stimulator-guided supraclavicular plexus block in upper limb surgeries

Subhadarshini,

Taksande,

Paul

2024

F1000Res

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Background Postoperative pain management is a crucial part of patient care for surgeries involving the upper limbs. A popular technique for providing both postoperative analgesia and regional anaesthesia is a supraclavicular plexus block guided by a peripheral nerve stimulator. Recent research has demonstrated that the analgesic effect of ropivacaine, a common local anaesthetic, can be enhanced by the addition of magnesium sulphate. The study aims to assess the safety and effectiveness of utilising magnesium sulphate in addition to ropivacaine alone for postoperative analgesia in patients having upper limb surgeries under peripheral nerve stimulator-guided supraclavicular plexus block. Methods This protocol outlines a prospective, double-blind, randomised, controlled trial that assesses the efficacy of ropivacaine versus ropivacaine plus magnesium sulphate for analgesia post surgery in patients undergoing upper limb surgeries under the guidance of a peripheral nerve stimulator (PNS). 50 Patients will be included in the study in total, and they will be split into two groups at random. PNS-guided supraclavicular plexus block with ropivacaine alone will be administered to one group, while ropivacaine combined with magnesium sulphate will be administered to the other. Regular monitoring will be done during the postoperative phase to determine pain levels, use of analgesics, motor and sensory blockade, and adverse events. Results The study aims to determine if ropivacaine with magnesium sulphate postoperative analgesia is superior to ropivacaine alone in supraclavicular plexus blocks. The motor and sensory blockade duration, opioid use, and any negative results will be evaluated as secondary outcomes. Statistical analysis will be performed to determine the significance of the differences between the two groups. Conclusion This study protocol compares the effectiveness of ropivacaine alone against ropivacaine with magnesium sulphate in peripheral nerve stimulator-guided supraclavicular plexus block, with the goal of adding to the repository of information on postoperative analgesia in upper limb procedures. The study’s findings could be very helpful in enhancing pain management strategies and enhancing patient outcomes in this context.

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Section: Discussionmentioning

confidence: 99%

To compare the efficacy of ropivacaine alone versus ropivacaine with magnesium sulphate for postoperative analgesia in peripheral nerve stimulator-guided supraclavicular plexus block in upper limb surgeries

Subhadarshini,

Taksande,

Paul

2024

F1000Res

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“…Several adjuvants, such as adrenaline, dexamethasone, and dexmedetomidine, are commonly added to ropivacaine for BPB to achieve better analgesic effects ( Bharti et al, 2015 ; Kumari et al, 2020 ; Grelet et al, 2021 ; Lee et al, 2021 ; Mar et al, 2021 ; Pande et al, 2021 ; Venkatraman et al, 2021 ; Xuan et al, 2021 ). Therefore, we further explored the possible effects of adding adjuvants to ropivacaine on our results.…”

Section: Discussionmentioning

confidence: 99%

Optimal concentration of ropivacaine for brachial plexus blocks in adult patients undergoing upper limb surgeries: a systematic review and meta-analysis

Wu,

Zhang,

Zhang

et al. 2023

Front. Pharmacol.

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Aim of the Study: Brachial plexus block (BPB) is widely used for patients undergoing upper limb surgeries. Ropivacaine is the most commonly used local anesthetic for BPB. This study aimed to identify the optimal ropivacaine concentration for BPB in adult patients undergoing upper limb surgeries.Materials and Methods: PubMed, Embase, the Cochrane Library, and Web of Science were searched to identify randomized controlled trials (RCTs) that compared the effects of different concentrations of ropivacaine for BPB in adult patients undergoing upper limb surgeries. The primary outcomes were the onset time of sensory and motor block. RevMan 5.4 software was used for analysis. The GRADE approach was used to assess evidence quality.Results: Nine studies involving 504 patients were included. Compared to 0.5% ropivacaine, 0.75% ropivacaine shortened the onset time of sensory (WMD, −2.54; 95% CI; −4.84 to −0.24; <0.0001, moderate quality of evidence) and motor blockade (WMD, −2.46; 95% CI, −4.26 to −0.66; p = 0.01; moderate quality of evidence). However, 0.5% and 0.75% ropivacaine provided similar duration time of sensory (WMD, −0.07; 95% CI, −0.88 to 0.74; p = 0.81; high quality of evidence) and motor blockade (WMD, −0.24; 95% CI, −1.12 to 0.65; p = 0.55; high quality of evidence), as well as time to first request for oral analgesia (WMD, −1.57; 95% CI, −3.14 to 0.01; p = 0.5; moderate quality of evidence).Conclusion: Moderate-quality evidence suggested that, in terms of the onset time of sensory and motor blockade, 0.75% ropivacaine is a preferred concentration for BPB in upper limb surgeries.Systematic Review Registration: identifier CRD42023392145.

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“…A comparative analysis of clonidine and dexmedetomidine in supraclavicular blocks is important to know the benefits and potential side effects when used as an adjuvant with bupivacaine [10]. Other than benefits and side effects, factors such as the onset and duration of sensory and motor blockade, postoperative analgesia, and hemodynamic stability need to be compared.…”

Section: Introductionmentioning

confidence: 99%

Comparative Study of Bupivacaine With Dexmedetomidine Versus Bupivacaine With Clonidine for Supraclavicular Brachial Plexus Block for Upper Limb Surgeries

KALLURI SAIPRIYANKA,

NAGAJYOTHI J

2024

Asian J Pharm Clin Res

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Objective: To compare the efficacy of clonidine with dexmedetomidine as an adjunct to bupivacaine in patients undergoing upper limb surgeries under supraclavicular brachial plexus block. Methods: This was a prospective comparative study conducted in the department of anesthesiology of a tertiary care medical institute. 80 patients undergoing various upper-limb surgeries were included in this study. Patients were divided into two groups on the basis of whether they received Clonidine (Group C) or Dexmedetomidine (Group D) as an adjuvant to Bupivacaine for supraclavicular block. The onset as well as duration of sensory and motor blockade, duration of analgesia, quality of anesthesia, hemodynamics, and adverse effects were compared between the two groups. p<0.05 was considered statistically significant. Results: The gender distribution of cases in Group C and Group D was found to be comparable, with no statistically significant difference. The mean age of patients in both groups was found to be comparable with no significant difference (p=0.5671). The most common types of surgeries in the studied cases were those of the lower radius and ulna (28.75%), followed by the lower humerus (21.25%), upper radius, and ulna (20%). The mean duration of sensory and motor block and duration of analgesia were found to be higher in group D as compared to group C, and the difference was found to be statistically highly significant (p<0.0001). The quality of anesthesia was better in patients who received dexmedetomidine as compared to those who received clonidine with Bupivacaine. Conclusion: Dexmedetomidine used as an adjuvant with bupivacaine for brachial plexus block is associated with prolonged duration of sensory as well as motor block and duration of analgesia as compared to when clonidine is used as an adjuvant. It is also associated with a better quality of anesthesia.

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To compare the efficacy of postoperative analgesia between clonidine and dexmedetomidine as adjuvants with 0.5% ropivacaine by ultrasound-guided supraclavicular brachial plexus block for upper limb surgeries: A prospective, double-blind, randomized study

Cited by 5 publications

References 24 publications

To compare the efficacy of ropivacaine alone versus ropivacaine with magnesium sulphate for postoperative analgesia in peripheral nerve stimulator-guided supraclavicular plexus block in upper limb surgeries

To compare the efficacy of ropivacaine alone versus ropivacaine with magnesium sulphate for postoperative analgesia in peripheral nerve stimulator-guided supraclavicular plexus block in upper limb surgeries

Optimal concentration of ropivacaine for brachial plexus blocks in adult patients undergoing upper limb surgeries: a systematic review and meta-analysis

Comparative Study of Bupivacaine With Dexmedetomidine Versus Bupivacaine With Clonidine for Supraclavicular Brachial Plexus Block for Upper Limb Surgeries

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