title: Dexmedetomidine Added to Local Anesthetic Mixture of Lidocaine and Ropivacaine Enhances Onset and Prolongs Duration of a Popliteal Approach to Sciatic Nerve Blockade.
abstract: A literature review of multiple clinical studies on mixing additives to improve pharmacologic limitation of local anesthetics during peripheral nerve blockade revealed inconsistency in success rates and various adverse effects. Animal research on dexmedetomidine as an adjuvant on the other hand has promising results, with evidence of minimum unwanted results. This randomized, double-blinded, contrastable observational study examined the efficacy of adding dexmedetomidine to a mixture of lidocaine plus ropivacaine during popliteal sciatic nerve blockade (PSNB).
  
  
  
  Sixty patients undergoing varicose saphenous vein resection using ultrasonography-guided PSNB along with femoral and obturator nerve blocks as surgical anesthesia were enrolled. All received standardized femoral and obturator nerve blocks, and the PSNB group was randomized to receive either 0.5 mL (50 µg) of dexmedetomidine (DL group) or 0.5 mL of saline (SL group) together with 2% lidocaine (9.5 mL) plus 0.75% ropovacaine (10 mL). Sensory onset and duration of lateral sural cutaneous nerve, sural nerve, superficial peroneal nerve, deep peroneal nerve, lateral plantar nerve, and medial plantar nerve were recorded. Motor onset and duration of tibial nerve and common peroneal nerve were also examined.
  
  
  
  Sensory onset of sural nerve, superficial peroneal nerve, lateral plantar nerve, and medial plantar nerve was significantly quicker in the DL group than in the SL group (P < 0.05). Sensory onset of lateral sural cutaneous nerve and deep peroneal nerve was not statistically different between the groups (P > 0.05). Motor onset of tibial nerve and common peroneal nerve was faster in the DL group than in in the SL group (P < 0.05). Duration of both sensory and motor blockade was significantly longer in the DL group than in the SL group (P < 0.05).
  
  
  
  Perineural dexmedetomidine added to lidocaine and ropivacaine enhanced efficacy of popliteal approach to sciatic nerve blockade with faster onset and longer duration.
authors.affiliation: Department of Anaesthesiology, First Affiliated Hospital, Wenzhou Medical University, Zhejiang, China; Department of Anaesthesiology, Wenzhou People's Hospital, Zhejiang, China.
authors.forename: Xiawei
authors.initials: X
authors.lastname: Hu
authors.affiliation: Department of Anaesthesiology, Yale New Haven Hospital, Yale University, New Haven, Connecticut.
authors.forename: Jinlei
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Anaesthesiology, First Affiliated Hospital, Wenzhou Medical University, Zhejiang, China.
authors.forename: Riyong
authors.initials: R
authors.lastname: Zhou
authors.affiliation: Department of Anaesthesiology, First Affiliated Hospital, Wenzhou Medical University, Zhejiang, China.
authors.forename: Quanguang
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Department of Anaesthesiology, First Affiliated Hospital, Wenzhou Medical University, Zhejiang, China.
authors.forename: Fangfang
authors.initials: F
authors.lastname: Xia
authors.affiliation: Department of Anaesthesiology, Yale New Haven Hospital, Yale University, New Haven, Connecticut.
authors.forename: Thomas
authors.initials: T
authors.lastname: Halaszynski
authors.affiliation: Department of Anaesthesiology, First Affiliated Hospital, Wenzhou Medical University, Zhejiang, China. Electronic address: xuzhong@263.net.
authors.forename: Xuzhong
authors.initials: X
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000577:Amides / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage*; D000818:Animals; D020927:Dexmedetomidine / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D000077212:Ropivacaine; D012584:Sciatic Nerve
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D020927:Dexmedetomidine; D000077212:Ropivacaine; D008012:Lidocaine
keywords: adjuvant; adrenergic α(2)-receptor agonists; dexmedetomidine; peripheral nerve blockade; sciatic nerve; ultrasonography