Dexmedetomidine in emergency hand surgery as an adjuvant to ropivacaine-induced supraclavicular brachial plexus block: a prospective, double-blinded and randomized controlled study

• Published in: Journal of evolution of medical and dental sciences p. 16320
• Main Authors: Mandal, Sudipta Kumar, Das, Koyel, Das, Anjan, Basak, Subhadeep, Bisai, Subrata, Bhattacharya, Saptarshi
• Format: Journal Article
• Language: English
• Published: Akshantala Enterprises Private Limited 07.12.2015
• Subjects: Anesthesia; Hand; Injuries; Orthopedic surgery
• ISSN: 2278-4748; 2278-4802
• DOI: 10.14260/jemds/2015/2409

Accidental industrial hand injury very often requires early intervention. Assuming as full stomach condition, regional anaesthesia is preferred to avoid the risk of aspiration in general anaesthesia. Different additives have been used to prolong the duration of brachial plexus block. We evaluated the effect of adding dexmedetomidine to ropivacaine for supraclavicular brachial plexus blockade. The primary endpoints were the onset and duration of sensory and motor block and duration of analgesia. MATERIALS AND METHODS Seventy six patients aged 20-50 years with ASA grade I, II who were presented with industrial hand injury and required emergency operative interventions were randomly allocated into two groups. Group-RD (n=38) received ropivacaine (30ml 0.5%) with dexmedetomidine 1ml (100µg) and patients in group-RP (n=38) received ropivacaine (30ml 0.5%) with 0.9% normal saline 1ml solution as placebo. Sensory and motor block onset times and durations, time to first analgesic use, total analgesic need, postoperative VAS, hemodynamics and side effects were recorded for each patient. RESULTS Though having comparable demographic profile, the onset of motor and sensory block was significantly fastened by dexmedetomidine (p<0.05). Sensory and motor block duration and time to first analgesic use were significantly prolonged and the total need for rescue analgesics was lower in group RD (P<0.05) than group RD. Postoperative VAS value at 12 hours were significantly lower in group RD (P<0.05). Side effects and hemodynamics were quite comparable among two groups. CONCLUSION It can be concluded that adding dexmedetomidine to brachial plexus block increases the sensory and motor block duration and time to first analgesic use and decreases block onset time and total analgesic use with no side effects. KEYWORDS Industrial Hand Injury, Dexmedetomidine, Ropivacaine, Supraclavicular Brachial Plexus Block.