A Study to Compare the Efficacy of Dexmedetomidine and Fentanyl as Adjuvants to Ropivacaine in USG Guided Axillary Block for Upper Limb Surgeries

A BSTRACT Background: The search for ideal adjuvants to local anesthetics continues to be an area of active research in regional anesthesia. In this study, the effectiveness of fentanyl and dexmedetomidine as adjuvants to ropivacaine in ultrasound-guided axillary brachial plexus block was compared. Methods: Two groups of forty ASA I–II patients undergoing upper limb surgery were randomly assigned. Twenty members of Group F received twenty-four milliliters of 0.5% ropivacaine with 0.5 μg/kg fentanyl, while twenty members of Group D received twenty-four milliliters of 0.5% ropivacaine with 0.5 μg/kg dexmedetomidine. Hemodynamic parameters, side effects, time to initial rescue analgesia and the onset and duration of sensory and motor blockage were all compared. Results: The Dexmedetomidine group showed significantly faster onset of sensory (8.2 ± 1.4 vs. 11.5 ± 1.8 minutes) and motor block (12.4 ± 2.1 vs. 15.8 ± 2.4 minutes). Block duration was longer in Group D (sensory: 846.5 ± 42.3 vs. 685.4 ± 38.7 minutes; motor: 782.3 ± 35.6 vs. 642.8 ± 32.4 minutes). Time to first rescue analgesia was significantly prolonged in Group D (892.4 ± 45.8 vs. 724.6 ± 41.2 minutes). VAS scores were lower in Group D after 8 hours. Hemodynamic parameters remained stable in both groups. Side effects were minimal and comparable between groups. Conclusion: Dexmedetomidine is superior to fentanyl as an adjuvant to ropivacaine in axillary brachial plexus block, providing faster onset, longer duration of analgesia, and stable hemodynamics.