title: Supraclavicular brachial plexus block using ropivacaine alone or combined with dexmedetomidine for upper limb surgery: A prospective, randomized, double-blinded, comparative study.
abstract: BACKGROUND
  Dexmedetomidine is a new α-2 receptor agonist with analgesic and sedative properties. We used dexmedetomidine along with ropivacaine for supraclavicular brachial plexus block.
  
  
  METHODS
  Eighty ASA grade I-II patients, 18-60 years old, scheduled for elective upper limb orthopaedic surgery under supraclavicular brachial plexus block, were included in this prospective study. The patients were randomly assigned to group R (ropivacaine alone) and group RD (ropivacaine and dexmedetomidine) (40 patients in each group). Group R received ropivacaine 0.50% (30 cc)+placebo and group RD received ropivacaine 0.50% (30 cc)+dexmedetomidine 1 μg/kg. Primary outcome measure was duration of analgesia. Secondary measures were onset and duration of sensory blockade, pain scores, onset and duration of motor blockade, and evidence of any adverse drug reactions.
  
  
  RESULTS
  There was no significant difference hemodynamic parameter during intra-operative period. Group RD showed a statistically significant shorter time to onset of sensory blockade (10.75±2.71 vs. 16.75±2.96 min, P=.003), longer sensory block duration (379.40±55.09 vs. 211.60±47.88 min, P=.002), shorter onset time to motor blockade (14.35±2.58 vs. 20.25±4.13 min, P=.003), longer motor block duration (312.0±49.91 vs. 184.7±36.76 min, P=.002), longer duration of postoperative analgesia (413.73±89.92 vs. 197.35±28.67 min, P=.002). Three patients in the group RD developed somnolence. (P=.04).
  
  
  CONCLUSIONS
  Dexmedetomidine along with ropivacaine decreases the onset of motor and sensory block and increases the duration of sensory and motor block in supraclavicular brachial plexus block.
authors.affiliation: Departamento de Anestesiología y Cuidados Críticos, Government Medical College, Haldwani, Uttarakhand, India. Electronic address: bikramjit.anesth@gmail.com.
authors.forename: B
authors.initials: B
authors.lastname: Das
authors.affiliation: J N Medical College, AMU Aligarh, Uttar Pradesh, India.
authors.forename: M
authors.initials: M
authors.lastname: Lakshmegowda
authors.affiliation: J N Medical College, AMU Aligarh, Uttar Pradesh, India.
authors.forename: M
authors.initials: M
authors.lastname: Sharma
authors.affiliation: Departamento de Anestesiología y Cuidados Críticos, Government Medical College, Haldwani, Uttarakhand, India.
authors.forename: S
authors.initials: S
authors.lastname: Mitra
authors.affiliation: Departamento de Anestesiología y Cuidados Críticos, Government Medical College, Haldwani, Uttarakhand, India.
authors.forename: R
authors.initials: R
authors.lastname: Chauhan
mesh_terms: D000293:Adolescent; D000328:Adult; D000577:Amides; D000772:Anesthesia, Local; D000779:Anesthetics, Local; D001917:Brachial Plexus; D065527:Brachial Plexus Block; D020927:Dexmedetomidine; D006801:Humans; D008875:Middle Aged; D009407:Nerve Block; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D020927:Dexmedetomidine
keywords: Bloqueo supraclavicular del plexo braquial; Dexmedetomidina; Dexmedetomidine; Ropivacaine; Ropivacaína; Supraclavicular brachial plexus block