A comparative study between 0.375% ropivacaine with 50mcg of dexmedetomidine and 0.375% ropivacaine with 8mg of dexamethasone for ultrasound guided supraclavicular brachial plexus block

Ultrasound has been increasingly used for nerve blocks as it shows precise location of nerve plexus, its surrounding vessels, reduces the injury to nerves and also avoids accidental intravascular injection as we can see the needle location and drug distribution. Various additives were used over the years. We used Dexmedetomidine and Dexamethasone as adjuvants to Ropivacaine for orthopaedic upper limb surgeries.

To assess and compare the effects of Dexmedetomidine and Dexamethasone on onset and duration of sensory and motor block when added to Ropivacaine for supraclavicular brachial plexus block.

This randomized double blind study was conducted in 60 ASA grade I and II patients posted for elective hand surgeries under ultrasound guided supraclavicular brachial plexus block after obtaining informed consent. Patients were divided into two equal groups of 30 each. Group DX patients received 0.375% Ropivacaine(30ml) + Dexmedetomidine 50 mcg (0.5 ml) + normal saline(1.5ml) and Group DM patients received 0.375% Ropivacaine(30ml) + Dexamethasone 8 mg(2 ml). Sensory and motor block onset and durations were recorded.

We observed early onset of sensory and motor block in group DX in comparison with DM (p<0.005). Duration of Sensory and motor block was prolonged in Group DX than Group DM (p<0.0001). Intra-operative hemodynamics were similar in two groups (P > 0.05).

We conclude that Dexmedetomidine added to Ropivacaine in ultrasound guided supraclavicular brachial plexus block is effective in reducing the onset time and prolongs the duration of sensory& motor blockade compared to Dexamethasone.