DEXAMETHASONE VERSUS DEXMEDETOMIDINE AS ADJUVANTS TO ROPIVACAINE FOR SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK- PROSPECTIVE, RANDOMISED, DOUBLE BLIND STUDY

Abstract

Background: Supraclavicular brachial plexus blockade (SBPB) is commonly performed regional anesthetic technique for forearm and hand surgeries, and its blockage provides good surgical anesthesia. Aim: Considering the efficacy of adjuvant for ropivacaine in SBPBs, we designed a double-blind randomized control study to compare the characteristics and side effects of ropivacaine along with dexamethasone versus dexmedetomidine in SBPBs in
patients scheduled for upper limb surgeries. Material and Methods: Present study was
single-center, prospective, randomised, double blind study, conducted patients aged 18-70
years, belonging to American Society of Anaesthesiologists physical status (ASA) of I or II,
scheduled for Upper limb surgeries under SBPB. Results: In present study, 108 patients were
studied, 54 patients received 20 ml 0.5% Ropivacaine with 50 mcg Dexamethasone (Group
A, n=54), while other 54 patients received 20 ml 0.5% Ropivacaine with 50 mcg
Dexmedetomidine (Group B, n=54). Age, weight, gender, ASA grade & duration of surgery
were comparable in both groups. Dexamethasone group has earlier onset of sensory block,
earlier onset of motor block, prolonged duration of sensory block & prolonged duration of
motor block as compared to dexmedetomidine group & difference was statistically significant
(p< 0.05). Dexamethasone group duration of analgesia, delayed first rescue analgesic
requirement & less doses of rescue analgesia required as compared to dexmedetomidine
group & difference was statistically significant (p< 0.05). Conclusion: Dexamethasone is a
better alternative than dexmedetomidine since it shortens the onset of sensory and motor
block, prolongs the duration of sensory and motor block and prolongs the duration of
analgesia.