Addition of Dexmedetomidine or Ketorolac to Levobupivacaine for Ultrasound Guided Supraclavicular Brachial Plexus Block

We compared the effects of dexmedetomidine and ketorolac as an adjuvant to levobupivacaine in ultrasound guided supraclavicular brachial plexus block, on postoperative analgesia and rescue analgesic requirement following upper limb orthopaedic surgery.

A prospective, randomized, double blinded comparative study.

A total number of 70, American society of Anaesthesiologist (ASA) class I and II patients, scheduled for elective upper limb orthopaedic surgeries under ultrasound guided supraclavicular brachial plexus block, were randomly assigned into two equal groups. Group D (n=35) received 0.5% levobupivacaine-20 mL + (100 mcg) dexmedetomidine-1ml + normal saline-4 ml and Group K (n=35) received 0.5% levobupivacaine-20 mL + (30mg) ketorolac-1ml + normal saline-4ml. Onset & duration of sensory and motor blocks, first time to analgesic request, total rescue analgesic demand, hemodynamic parameters and side effects were assessed and recorded.

Onset of sensory and motor blockade was 9.19±2.18 min and 10.72±4.1 min in group D, while it was 12.31±4.11 min and 15.49±2.31 min in group K, respectively. The difference was statistically significant (p<0.05). Duration of sensory block was 177±64 min in group D and 130±28 min in group K (p=0.023). Duration of motor block was 163±59 min in group D and 101±47 min in group K (p= 0.011). Duration of analgesia was 292±93 min in group D and 218±67 min in group K (p= 0.026).

In conclusion, dexmedetomidine had better effects on onset and duration of sensory and motor block as well as prolong the demand for rescue analgesia in comparison with ketorolac, as levobupivacaine adjuvant in supraclavicular brachial block.