A COMPARATIVE STUDY OF DEXMEDITOMEDINE AND DEXAMETHASONE AS ADJUVANTS TO LOCAL ANESTHETICS IN BRACHIAL PLEXUS BLOCK FOR UPPER LIMB SURGERIES
- Department of Anesthesiology, Santhiram Medical College, Nandyal.
- Abstract
- Keywords
- References
- Cite This Article as
- Corresponding Author
Objective: To compare and evaluate the onset time and duration of sensory, motor block, and quality of intraoperative and postoperative analgesia of dexmedetomidine and dexamethasone as adjuvants to local anesthetics in brachial plexus block. Methods: This was a prospective comparative study conducted among 60 adult patients aged 18-60yrs belonging to asa 1& 2 posted for upper limb surgeries. 1. Group-a: 20ml of 2% lignocaine with adrenaline + 20ml of 0.5% bupivacaine+ 20mcgs of dexmeditomedine. 2. Group-b: 20ml of 2% lignocaine with adrenaline + 20ml of 0.5% bupivacaine+ 4mg dexamethasone. Results: The groups were similar in age, hemodynamic parameters like intra and post-operative heart rate, mean arterial pressure. In this study, the onset and duration of sensory and motor blockade were statistically shorter in the dexamethasone group when compared to the dexmedetomidine group. Conclusion: The present study concludes both dexmedetomidine and dexamethasone act as functional additives with dexmedetomidine having the advantage of conscious sedation and hemodynamic stability prolongs the duration of block whereas the onset of the block was shorter when dexamethasone was added.
- Raimo V, Juha M, VeijoS, Leena N, Virtanen R. Characterisation of selectivity, specificity and potency of dexmeditomedine as alpha 2 adrenoceptoragonist.EUR J Pharmacol.1988;150:9-14.
- Yoshitomi T, Kohjitani A, Maeda S, Higchi H. Dexmeditomedine enhances the local anesthetic action of lidocaine via an alpha2A adrenoceptor. Anesth Analog.2008;107:96-101.
- Esmaoglu A, Yegenoglu F, Akin A, Turk CY. Dexmeditomedine added to levobupivacaine prolongs the axillary brachial plexus block. Anesth Analog.2010;111:1548-51.
- Verma NK, Ranjan A. A Clinical comparison of dexamethasone and dexmeditomedine as asdjuvants to ropivacaine in supraclavicular brachial plexus block for upper limb surgery.Int J Adv Res Biol Sci.2016;3(7):56-61.
- GolwalaMP,Swadia VN, Dhimar AA, Sridhar NV. Pain relief by dexamethasone as adjuvant to local anesthetics in supraclavicular brachial plexus block. J AnesthClin Pharmacol.2009:25(3):285-88.
- Liu K, Hsu CC, Chia YY. Effect of dexamethasone on postoperative pain and emesis. Br J Anesth. 1998;80;85-6.
- Amany S Ammar, Khaled M Mahmoud. Ultrasound-guided single injection infraclavicular brachial plexus block using bupivacaine alone or combined with dexmeditomedine for pain control in upper limb surgery: A prospective randomized controlled trial. Saudi J Anesth.2012 Apr-Jun;6(2):109-114.
- Hari K, Rajgopal P, Binu PS et al. (2015): Comparison between 0.5% bupivacaine ? clonidine combination in brachial plexus block by supraclavicular approach. Journal of evidencebased Medicine and Healthcare,2(15):3016-3024.
- Saraiva PSF, Sabbag AT, Costa PDS, Brienz LA et al. Synergistic effect between dexmeditomedine and 0.75% ropivacaine in epidural anesthesia. Brazilian journal of medical 2008;54.
- El-hakim M, Ali NM, Rasheed. Dexamethasone reduces postoperative vomiting and pain after tonsillectomy. Can J Anesth 2003;50;392-97.
- Simpson D, Curran MP, Oldfield V, Keating GM, Ropivacaine A Review of its use in regional anesthesia and acute pain management. Drugs2005;65(18):2675-717.
- Agarwal S, Agarwal R, Gupta P. Dexmeditomedine prolongs the effect of bupivacaine in supraclavicular brachial plexus block. J Anesthesiol Cli Pharmacol.2014;30:36-40.
- Gerter R, Brown HC, Mitchell DH, Silvius EN. Dexmeditomedine: a novel sedative -analgesic agent. Proc (BaylUniv Med Cent).2001;14:13-21.
[Akkineni Vinisha, P. Vasu Prakash and K. Madhusudhan Reddy (2020); A COMPARATIVE STUDY OF DEXMEDITOMEDINE AND DEXAMETHASONE AS ADJUVANTS TO LOCAL ANESTHETICS IN BRACHIAL PLEXUS BLOCK FOR UPPER LIMB SURGERIES Int. J. of Adv. Res. 8 (Jan). 998-1002] (ISSN 2320-5407). www.journalijar.com