Dexmedetomidine versus Dexamethasone as Perineural Adjuvants in Supraclavicular Brachial Plexus Block: An Interventional Study
Introduction: Supraclavicular block is a common regional anaesthetic technique for upper limb surgeries. Adjuvants like dexamethasone and dexmedetomidine can enhance the block’s efficacy and prolong the duration of anaesthesia and analgesia. Aim: To compare the effects of perineural dexamethasone v...
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JCDR Research and Publications Private Limited
2025-02-01
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| author | Charmi Hitenbhai Shah Jinesh Pareshbhai Kothari Nilesh Vrajmohan Shah Rajsi Rajan Shah Sara Mary Thomas |
| author_facet | Charmi Hitenbhai Shah Jinesh Pareshbhai Kothari Nilesh Vrajmohan Shah Rajsi Rajan Shah Sara Mary Thomas |
| author_sort | Charmi Hitenbhai Shah |
| collection | DOAJ |
| description | Introduction: Supraclavicular block is a common regional anaesthetic technique for upper limb surgeries. Adjuvants like dexamethasone and dexmedetomidine can enhance the block’s efficacy and prolong the duration of anaesthesia and analgesia.
Aim: To compare the effects of perineural dexamethasone versus perineural dexmedetomidine added to a local anaesthetic mixture in supraclavicular brachial plexus block for upper limb surgeries.
Materials and Methods: This interventional study was conducted in the Department of Anaesthesiology at Dhiraj Hospital, Vadodara, Gujarat, India from October 2023 to April 2024 on 80 patients with American Society of Anaesthesiologists (ASA) physical status I and II, aged 18 to 65 years, scheduled for surgery under supraclavicular brachial plexus block. Patients were allocated into two groups of 40 patients each. Group 1 received 12 mL of 0.2% lignocaine with adrenaline and 13 mL of 0.5% bupivacaine along with dexmedetomidine 50 mcg. Group 2 received the same local anaesthetic mixture with dexamethasone 8 mg (2 mL). The onset and duration of sensory and motor blocks, haemodynamic changes {variations in pulse, blood pressure, and oxygen saturation (SpO2)}, duration of rescue analgesia, side-effects, and complications were evaluated. Chi-square test and t-test were applied for statistical evaluation.
Results: Group 1 had a significantly lower average age (35.38±9.03 years) compared to Group 2 (46.40±13.12 years) (p=0.000039). Group 1 had a slower onset of sensory and motor blockade compared to Group 2 (14.38±2.19 minutes vs. 13.00±1.89 minutes, p=0.0036; 16.20±2.14 minutes vs. 15.70±1.99 minutes). Group 2 also showed significantly longer durations for motor blockade (918.75±65.80 minutes vs. 632.60±23.09 minutes, p=3.10×10-44), postoperative analgesia (1051.00±90.18 minutes vs. 811.12±17.23 minutes, p=1.00×10-28),
and time for rescue analgesia (1116.75±93.96 minutes vs. 826.50±13.92 minutes, p=2.40×10-32). Haemodynamics and SpO2 were comparable between the two groups.
Conclusion: Dexamethasone, as an adjuvant to a local anaesthetic mixture in supraclavicular brachial plexus block, provided excellent quality of postoperative analgesia with minimal side-effects. However, the incidence of hypotension and bradycardia was higher with dexmedetomidine, which could be managed with routine clinical measures. |
| format | Article |
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| institution | Kabale University |
| issn | 2249-782X 0973-709X |
| language | English |
| publishDate | 2025-02-01 |
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| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj-art-82b131a230b0449bba4d28c5bf9fcbd12025-02-10T11:55:18ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2025-02-011802182210.7860/JCDR/2025/75246.20582Dexmedetomidine versus Dexamethasone as Perineural Adjuvants in Supraclavicular Brachial Plexus Block: An Interventional StudyCharmi Hitenbhai Shah0Jinesh Pareshbhai Kothari1Nilesh Vrajmohan Shah2Rajsi Rajan Shah3Sara Mary Thomas4Assistant Professor, Department of Anaesthesia, Shrimati Bhikhiben Kanjibhai Shah Medical Institute and Research Centre, Sumandeep Vidyapeeth (Deemed to be University), Vadodara, Gujarat, IndiaThird Year Resident, Department of Anaesthesia, Shrimati Bhikhiben Kanjibhai Shah Medical Institute and Research Centre, Sumandeep Vidyapeeth (Deemed to be University), Vadodara, Gujarat, India.Professor, Department of Anaesthesia, Shrimati Bhikhiben Kanjibhai Shah Medical Institute and Research Centre, Sumandeep Vidyapeeth (Deemed to be University), Vadodara, Gujarat, India.Assistant Professor, Department of Anaesthesia, Shrimati Bhikhiben Kanjibhai Shah Medical Institute and Research Centre, Sumandeep Vidyapeeth (Deemed to be University), Vadodara, Gujarat, India.Professor and Head, Department of Anaesthesia, Shrimati Bhikhiben Kanjibhai Shah Medical Institute and Research Centre, Sumandeep Vidyapeeth (Deemed to be University), Vadodara, Gujarat, India.Introduction: Supraclavicular block is a common regional anaesthetic technique for upper limb surgeries. Adjuvants like dexamethasone and dexmedetomidine can enhance the block’s efficacy and prolong the duration of anaesthesia and analgesia. Aim: To compare the effects of perineural dexamethasone versus perineural dexmedetomidine added to a local anaesthetic mixture in supraclavicular brachial plexus block for upper limb surgeries. Materials and Methods: This interventional study was conducted in the Department of Anaesthesiology at Dhiraj Hospital, Vadodara, Gujarat, India from October 2023 to April 2024 on 80 patients with American Society of Anaesthesiologists (ASA) physical status I and II, aged 18 to 65 years, scheduled for surgery under supraclavicular brachial plexus block. Patients were allocated into two groups of 40 patients each. Group 1 received 12 mL of 0.2% lignocaine with adrenaline and 13 mL of 0.5% bupivacaine along with dexmedetomidine 50 mcg. Group 2 received the same local anaesthetic mixture with dexamethasone 8 mg (2 mL). The onset and duration of sensory and motor blocks, haemodynamic changes {variations in pulse, blood pressure, and oxygen saturation (SpO2)}, duration of rescue analgesia, side-effects, and complications were evaluated. Chi-square test and t-test were applied for statistical evaluation. Results: Group 1 had a significantly lower average age (35.38±9.03 years) compared to Group 2 (46.40±13.12 years) (p=0.000039). Group 1 had a slower onset of sensory and motor blockade compared to Group 2 (14.38±2.19 minutes vs. 13.00±1.89 minutes, p=0.0036; 16.20±2.14 minutes vs. 15.70±1.99 minutes). Group 2 also showed significantly longer durations for motor blockade (918.75±65.80 minutes vs. 632.60±23.09 minutes, p=3.10×10-44), postoperative analgesia (1051.00±90.18 minutes vs. 811.12±17.23 minutes, p=1.00×10-28), and time for rescue analgesia (1116.75±93.96 minutes vs. 826.50±13.92 minutes, p=2.40×10-32). Haemodynamics and SpO2 were comparable between the two groups. Conclusion: Dexamethasone, as an adjuvant to a local anaesthetic mixture in supraclavicular brachial plexus block, provided excellent quality of postoperative analgesia with minimal side-effects. However, the incidence of hypotension and bradycardia was higher with dexmedetomidine, which could be managed with routine clinical measures.https://jcdr.net/articles/PDF/20582/75246_CE[Ra1]_F(SL)_PF1(VD_SS)_redo_PFA_NC(IS)_PN(IS).pdfbradycardiabupivacainepostoperative analgesiasupraclavicular block |
| spellingShingle | Charmi Hitenbhai Shah Jinesh Pareshbhai Kothari Nilesh Vrajmohan Shah Rajsi Rajan Shah Sara Mary Thomas Dexmedetomidine versus Dexamethasone as Perineural Adjuvants in Supraclavicular Brachial Plexus Block: An Interventional Study Journal of Clinical and Diagnostic Research bradycardia bupivacaine postoperative analgesia supraclavicular block |
| title | Dexmedetomidine versus Dexamethasone as Perineural Adjuvants in Supraclavicular Brachial Plexus Block: An Interventional Study |
| title_full | Dexmedetomidine versus Dexamethasone as Perineural Adjuvants in Supraclavicular Brachial Plexus Block: An Interventional Study |
| title_fullStr | Dexmedetomidine versus Dexamethasone as Perineural Adjuvants in Supraclavicular Brachial Plexus Block: An Interventional Study |
| title_full_unstemmed | Dexmedetomidine versus Dexamethasone as Perineural Adjuvants in Supraclavicular Brachial Plexus Block: An Interventional Study |
| title_short | Dexmedetomidine versus Dexamethasone as Perineural Adjuvants in Supraclavicular Brachial Plexus Block: An Interventional Study |
| title_sort | dexmedetomidine versus dexamethasone as perineural adjuvants in supraclavicular brachial plexus block an interventional study |
| topic | bradycardia bupivacaine postoperative analgesia supraclavicular block |
| url | https://jcdr.net/articles/PDF/20582/75246_CE[Ra1]_F(SL)_PF1(VD_SS)_redo_PFA_NC(IS)_PN(IS).pdf |
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