Comparison of dexmedetomidine and epinephrine as an adjuvant to 1% mepivacaine in brachial plexus block.
BACKGROUND
Dexmedetomidine extends the duration of nerve block when administered perineurally together with local anesthetics by central and/or peripheral action. In this study, we compared the duration of nerve block between dexmedetomidine and epinephrine as an adjuvant to 1% mepivacaine in infraclavicular brachial plexus block.


METHODS
Thirty patients, scheduled for upper limb surgery were assigned randomly to 3 groups of 10 patients each. We performed brachial plexus block using a nerve stimulator. In the control group (group C), patients received 40 ml of 1% mepivacaine. In group E, patients received 40 ml of 1% mepivacaine containing 200 µg of epinephrine as an adjuvant. In group D, patients received 40 ml of 1% mepivacaine containing 1 µg/kg of dexmedetomidine as an adjuvant. Sensory block duration, motor block duration, time to sense pain, and onset time were assessed. We also monitored blood pressure, heart rate, oxygen saturation and bispectral index.


RESULTS
In group D and group E, sensory block duration, motor block duration and time to sense first pain were prolonged significantly compared to group C. However, there was no significant difference between group D and group E.


CONCLUSIONS
Perineural 1 µg/kg of dexmedetomidine similarly prolonged nerve block duration compared to 200 µg of epinephrine, but slowed heart rate. Thus, dexmedetomidine is expected to be a good alternative as an adjuvant to local anesthesia in patients who are cautioned against epinephrine.
Department of Anesthesiology and Pain Medicine, Inha University School of Medicine, Incheon, Korea.
Jang-Ho
JH
Song
Department of Anesthesiology and Pain Medicine, Inha University School of Medicine, Incheon, Korea.
Hee Yong
HY
Shim
Department of Orthopedic Surgery, Inha University School of Medicine, Incheon, Korea.
Tong Joo
TJ
Lee
Department of Anesthesiology and Pain Medicine, Inha University School of Medicine, Incheon, Korea.
Jong-Kwon
JK
Jung
Department of Anesthesiology and Pain Medicine, Inha University School of Medicine, Incheon, Korea.
Young-Deog
YD
Cha
Department of Anesthesiology and Pain Medicine, Inha University School of Medicine, Incheon, Korea.
Doo Ik
DI
Lee
Department of Anesthesiology and Pain Medicine, Inha University School of Medicine, Incheon, Korea.
Gun Woo
GW
Kim
Department of Anesthesiology and Pain Medicine, Inha University School of Medicine, Incheon, Korea.
Jeong Uk
JU
Han
Brachial plexus; Dexmedetomidine; Epinephrine