Abstract

Background: Infraclavicular brachial plexus blockade provides anesthesia for surgeries of upper limb. In contrast to interscalene and supraclavicular block, infraclavicular blockade has the advantage of minimal risk to intravertebral, intrathecal or epidural injection, as well as reduced incidence of phrenic nerve and stellate ganglion block.

Aim: To evaluate the effect of dexmedetomidine with bupivacaine on the onset and duration of sensory and motor block and duration of analgesia in infraclavicular blocks.

Methodology: A prospective, double blind, randomized control trial was conducted among 50 patients under going elective surgery of hand, for earm, elbow and distal humerus. Patients were randomly divided into two groups based on random numbers generated by a computer program (www.randomwqqqizer.org). Group A consisted 25 patients received block with bupivacaine + dexmedetomidine Group A and Group B consisted 25 patients received block with bupivacaine + 20 ml normal saline. This study compared Onset and duration of sensory and motor blockade, duration of analgesia, post-operative pain score and hemodynamic parameters between the two groups.

Results: There was significant difference in mean onset of sensory block between two groups, (Group A 9.20 ± 0.98 vs Group B 11.06 ± 1.24 min p value < 0.001. Similarly there was significant difference in mean onset of Motor blockade between two groups (Group A 10.66 ± 1.06 min vs Group B 11.80 ± 1.10 min p value < 0.001). There was a statistically significant longer duration of sensory block (Group A was 8.88 ± 1.04 hrs and in Group B was 7.60 ± 0.78 hrs, p value <0.001), longer duration of motor block (Group A was 7.79 ± 0.82 Hrs vs Group B was 6.62 ± 0.49 hrs p value < 0.001). Statistically significant longer duration of motor block

(Group A was 9.78 ± 0.73 vs Group B 6.99 ± 1.10 hrs p value < 0.001.

Conclusion: Dexmedetomidine as an adjuvant hastens the onset and prolongs the duration of both sensory and motor block and has better analgesia when compared to bupivacaine alone.

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Funding