A Comparison of Intravenous and Perineural Dexmedetomidine as Adjuvants to Ropivacaine in Supraclavicular Brachial Plexus Block in Upper Limb Surgery

Background: Many adjuvants have been explored in the past in numerous trials to extend the duration of analgesia in supraclavicular brachial plexus block, but the perfect adjuvant has not yet been found. It has been shown that adding dexmedetomidine, a selective Alfa-2 adrenergic agonist, to a local anaesthetic prolongs the block duration and post-operative analgesia in a variety of regional blocks. Aims and Objectives: The goals and objectives are to investigate the hemodynamic effects of adding dexmedetomidine with ropivacaine in supraclavicular brachial plexus block, as well as the start and duration of sensory and motor blockade and postoperative analgesia. Materials and Methods: Two groups of sixty patients, of both sexes and classified as class I and II by the American Society of Anesthesiologists and scheduled for upper limb surgery under supraclavicular brachial plexus block, were randomly assigned. The patients ranged in age from 18 to 60 years. Group B got 20 mL of 0.5% ropivacaine in brachial plexus block with dexmedetomidine intravenous infusion at 1 μg/kg over 10 min, whereas Group A received 20 mL of 0.5% ropivacaine in brachial plexus block with adjuvant perineurally at a dose of 1 μg/kg. Non-invasive intraoperative blood pressure, heart rate, SpO2, and sedation were monitored every 5 minutes during the first 10 minutes and then every 15 minutes until the conclusion. The initial rescue analgesic’s time, the postoperative pain’s severity, and the overall amount of analgesic needed were all noted. Results: Group A had sensory and motor block onset was more quickly than Group B. Group A had analgesia for a longer period of time than Group B. Group A maintained hemodynamic stability better than Group B. Group B sedation was superior. Conclusion: In supraclavicular brachial plexus blocks, dexmedetomidine is a more effective adjuvant than ropivacaine in terms of delivering a quicker start of motor and sensory blocks as well as a longer duration of postoperative analgesia with improved hemodynamic stability.