COMPARISON OF FENTANYL AND DEXMEDETOMIDINE AS AN ADJUVANT TO BUPIVACAINE IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK: A RANDOMIZED-DOUBLE BLIND  PROSPECTIVE STUDY

Swastika Swaro; Daisy Karan; Swarna Banerjee

doi:10.22159/ajpcr.2016.v9i5.11928

Authors

Swastika Swaro
Daisy Karan
Swarna Banerjee

DOI:

https://doi.org/10.22159/ajpcr.2016.v9i5.11928

Abstract

Objectives: Supraclavicular block of brachial plexus provides complete and reliable anesthesia for upper limb surgeries. Using adjuvant to local
anesthetics, blocks can be prolonged to long durations. Peripheral nerve blocks thus help in avoiding the hazards of general anesthesia. We compared
the sensory blockade, motor blockade, and duration of analgesia with the addition of fentanyl or dexmedetomidine to bupivacaine for supraclavicular
brachial plexus block.

Methods: A total of 50 American Society of Anesthesiologist's Physical Status I and II patients scheduled for elective upper limb surgeries under
supraclavicular brachial plexus block were divided into two equal groups in a randomized double-blinded fashion. Group BF received 30 ml
bupivacaine with fentanyl 50 Î¼g and Group BD received 30 ml bupivacaine with dexmedetomidine 50 Î¼g. The characteristics for anesthesia and
analgesia were assessed in both groups.

Results: Duration of sensory and motor block was 363.4Â±38.36 minutes and 357Â±36.77 minutes, respectively, in Group BF while it was
452.96Â±77.12 minutes and 441.52Â±48.46 minutes in Group BD. There was a statistically significant difference in onset of sensory and motor
block between the two groups. The duration of analgesia (time to requirement of rescue analgesia) in Group BD was longer than in Group BF
(471.44Â±65.88 minutes vs. 366.48Â±38.02 minutes) with (p<0.0001). There were minimum hemodynamic disturbances and side effects in any group
except for Grade 3 sedation score which was more in Group BD.
Conclusion: Dexmedetomidine, when added to bupivacaine in supraclavicular brachial plexus block, enhanced the duration of sensory and motor block and also the duration of analgesia, more than when fentanyl was added to bupivacaine.

Keywords: Fentanyl, Dexmedetomidine, Bupivacaine, Supraclavicular brachial block.

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