Srinivasan Swaminathan

Abstract

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.

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