Analgesic Efficacy of Dexmedetomidine as an Adjuvant to Ropivacaine in Supraclavicular Brachial Plexus Block for Upper Limb Surgeries: A Prospective Randomized Study

Abstract

Background and Aims: The primary aim of this randomized controlled study was to evaluate the effect of the addition of dexmedetomidine to ropivacaine on the onset and duration of sensory and motor blockade and the duration of analgesia in patients undergoing upper limb surgeries under supraclavicular brachial plexus block. Materials and Methods: A total of 100 patients of age 18–55 years, planned for elective upper limb surgeries under supraclavicular brachial plexus block using a nerve stimulator, were randomly allocated into two groups. Group 1 (n = 50) received 30 mL 0.5% ropivacaine and 1 mL normal saline and Group 2 (n = 50) received 30 mL 0.5% ropivacaine and 1 μg/kg of dexmedetomidine. The onset and duration of sensory and motor block, duration of analgesia, and adverse events during the perioperative period were noted. Results: The onset of sensory and motor block in Group 1 (16. 26 ± 2.23 and 21.68 ± 2.90 min) was slower than those in Group 2 (9.12 ± 2.40 and 12.68 ± 2.62 min), (<0.001). The duration of sensory and motor block in Group 1 was significantly shorter than those in Group 2 (P < 0.001). The duration of analgesia in Group 1 (402.80 ± 28.21 min) was shorter than that in Group 2 (981.00 ± 92.26 min; P < 0.001). There was no statistically significant difference between the two groups in the incidence of the side effects, except in the incidence of sedation which is significantly higher in Group 2, (P < 0.001). Conclusion: Dexmedetomidine with ropivacaine for supraclavicular nerve block resulted in earlier onset and prolonged duration of the sensorimotor blockade and provided a longer pain-free postoperative period without significant hemodynamic alterations.