Supraclavicular brachial plexus block using ropivacaine alone or combined with dexmedetomidine for upper limb surgery: A prospective, randomized, double-blinded, comparative study.

BACKGROUND: Dexmedetomidine is a new α-2 receptor agonist with analgesic and sedative properties. We used dexmedetomidine along with ropivacaine for supraclavicular brachial plexus block. METHODS: Eighty ASA grade I-II patients, 18-60 years old, scheduled for elective upper limb orthopaedic surgery under supraclavicular brachial plexus block, were included in this prospective study. The patients were randomly assigned to group R (ropivacaine alone) and group RD (ropivacaine and dexmedetomidine) (40 patients in each group). Group R received ropivacaine 0.50% (30 cc)+placebo and group RD received ropivacaine 0.50% (30 cc)+dexmedetomidine 1 µg/kg. Primary outcome measure was duration of analgesia. Secondary measures were onset and duration of sensory blockade, pain scores, onset and duration of motor blockade, and evidence of any adverse drug reactions. RESULTS: There was no significant difference hemodynamic parameter during intra-operative period. Group RD showed a statistically significant shorter time to onset of sensory blockade (10.75±2.71 vs. 16.75±2.96 min, P=.003), longer sensory block duration (379.40±55.09 vs. 211.60±47.88 min, P=.002), shorter onset time to motor blockade (14.35±2.58 vs. 20.25±4.13 min, P=.003), longer motor block duration (312.0±49.91 vs. 184.7±36.76 min, P=.002), longer duration of postoperative analgesia (413.73±89.92 vs. 197.35±28.67 min, P=.002). Three patients in the group RD developed somnolence. (P=.04). CONCLUSION: Dexmedetomidine along with ropivacaine decreases the onset of motor and sensory block and increases the duration of sensory and motor block in supraclavicular brachial plexus block.

Bloqueo supraclavicular del plexo braquial con ropivacaína sola o en combinación con dexmedetomidina en cirugías de extremidades superiores: ensayo comparativo, prospectivo, monitorización y con doble enmascaramiento / Supraclavicular brachial plexus block using ropivacaine alone or combined with dexmedetomidine for upper limb surgery: A prospective, randomized, double-blinded, comparative study

Antecedentes. La dexmedetomidina es un nuevo agonista de los receptores α2 con propiedades analgésicas y sedantes. Utilizamos dexmedetomidina junto con ropivacaína para realizar un bloqueo supraclavicular del plexo braquial. Métodos. En esta investigación se incluyeron 80 pacientes ASA I-II, de 18-60 años, programados para cirugía ortopédica de extremidad superior con bloqueo supraclavicular del plexo braquial. A los pacientes (40 en cada grupo) se les asignó aleatoriamente el grupo R (solo ropivacaína) y el grupo RD (ropivacaína y dexmedetomidina). El grupo R recibió ropivacaína 0,50% (30 cc) + placebo y el grupo RD ropivacaína 0,50% (30 cc) y dexmedetomidina 1 μg/kg. El criterio de valoración primario fue la duración de la analgesia, mientras que los secundarios fueron el inicio y la duración del bloqueo sensitivo, las puntuaciones de dolor, el inicio y la duración del bloqueo motor y la reacción adversa a los fármacos. Resultados. No hubo diferencias significativas en los parámetros hemodinámicos durante el período intraoperatorio. El grupo RD presentó un tiempo significativamente más corto desde el punto de vista estadístico para el inicio del bloqueo sensitivo (10,75 ± 2,71 frente a 16,75 ± 2,96 min; p = 0,003), una duración más prolongada del bloqueo sensitivo (379,40 ± 55,09 frente a 211,60 ± 47,88 min; p = 0,002), un menor tiempo para el inicio del bloqueo motor (14,35 ± 2,58 frente a 20,25 ± 4,13 min; p = 0,003), una duración más prolongada del bloqueo motor (312 ± 49,91 frente a 184,7 ± 36,76 min; p = 0,002), y una duración más prolongada de la analgesia postoperatoria (413,73 ± 89,92 frente 197,35 ± 28,67 min; p = 0,002). Tres pacientes del grupo RD presentaron somnolencia (p = 0,04). Conclusión. La dexmedetomidina combinada con la ropivacaína reduce el inicio del bloqueo sensitivo y motor, y aumenta la duración del bloqueo sensitivo y motor en el bloqueo supraclavicular del plexo braquial (AU)

Background. Dexmedetomidine is a new α-2 receptor agonist with analgesic and sedative properties. We used dexmedetomidine along with ropivacaine for supraclavicular brachial plexus block. Methods. Eighty ASA grade I-II patients, 18-60 years old, scheduled forelective upper limb orthopaedic surgery under supraclavicular brachial plexus block, were included in this prospective study. The patients were randomly assigned to group R (ropivacaine alone) and group RD (ropivacaine and dexmedetomidine) (40 patients in each group). Group R received ropivacaine 0.50% (30 cc) + placebo and group RD received ropivacaine 0.50% (30 cc) + dexmedetomidine 1 μg/kg. Primary outcome measure was duration of analgesia. Secondary measures were onset and duration of sensory blockade, pain scores, onset and duration of motor blockade, and evidence of any adverse drug reactions. Results. There was no significant difference hemodynamic parameter during intra-operative period. Group RD showed a statistically significant shorter time to onset of sensory blockade (10.75 ± 2.71 vs. 16.75 ± 2.96 min, P = .003), longer sensory block duration (379.40 ± 55.09 vs. 211.60 ± 47.88 min, P = .002), shorter onset time to motor blockade (14.35 ± 2.58 vs. 20.25 ± 4.13 min, P = .003), longer motor block duration (312.0 ± 49.91 vs. 184.7 ± 36.76 min, P = .002), longer duration of postoperative analgesia (413.73 ± 89.92 vs. 197.35 ± 28.67 min, P = .002). Three patients in the group RD developed somnolence. (P = .04). Conclusion. Dexmedetomidine along with ropivacaine decreases the onset of motor and sensory block and increases the duration of sensory and motor block in supraclavicular brachial plexus block (AU)