Authors : Sethuramachandran Adinarayanan, Rashmi Chandran, Srinivasan Swaminathan, Gnanasekaran Srinivasan, Prasanna Udupi Bidkar
DOI : 10.18231/j.ijca.2019.102
Volume : 6
Issue : 4
Year : 2019
Page No : 523-527
Introduction: Supraclavicular brachial plexus block is one of the preferred technique to provide
perioperative anaesthesia and analgesia for upper limb surgical procedures. The duration of block can
be extended by the addition of various adjuvants. Our aim is to compare the efficacy of dexamethasone
and dexmedetomidine as an adjuvant to bupivacaine in extending the duration of supraclavicular brachial
plexus block and also to compare the pain scores and postoperative morphine consumption.
Materials and Methods: We randomised 90 patients scheduled for upper limb surgeries into three groups
with each group consisting of 30 patients in this prospective randomized study. All patients in the three
groups received 25 ml of 0.5% bupivacaine. Along with bupivacaine, Group A patients received 8 mg
(2 ml) of Dexamethasone, 1m gkg????1 (2ml) of dexmedetomidine in group B and 2 ml of normal saline in
group C. Postoperatively, all patients received morphine by patient cont rolled analgesia (PCA) and the
block characteristics, pain scores and total opioid consumption were noted.
Results: We noted a significantly extended motor block (1303.932 33.71 min vs 888.6257.92 min) and
extended sensory block (1619.29 235.49 vs 1084.14207.58 min) in dexamethasone group compared
with the dexmedetomidine group. The postoperative pain scores and morphine consumption were
comparable between the dexamethas one and dexmedetomidine groups.
Conclusion: As an adjuvant to bupivacaine, dexamethasone significantly extends the duration of
supraclavicular brachial plexus block compared to dexmedetomidine. Both the above two adjuvants are
effective in decreasing the posto perative morphine consumption.
Keywords: Supraclavicular block morphine bupivacaine dexamethasone dexmedetomidine.