COMPARISON OF THREE DIFFERENT DOSES OF DEXMEDETOMIDINE AS ADJUVANT TO BUPIVACAINE IN SUPRA CLAVICULAR BRACHIAL PLEXUS BLOCK FOR UPPER LIMB ORTHOPAEDIC SURGERIES A STUDY OF 60 CASES

Muthu Shenbagam; B. Dhanalakshmi

Volume : V, Issue : VIII, August - 2016

COMPARISON OF THREE DIFFERENT DOSES OF DEXMEDETOMIDINE AS ADJUVANT TO BUPIVACAINE IN SUPRA CLAVICULAR BRACHIAL PLEXUS BLOCK FOR UPPER LIMB ORTHOPAEDIC SURGERIES A STUDY OF 60 CASES

Muthu Shenbagam, B. Dhanalakshmi

Abstract :

Objective: The aim and objective of the study is to compare the three different doses of dexmedetomidine and to know the optimal dose of dexmedetomidine as adjuvant to bupivacaine in supra clavicular achial plexus block for upper limb orthopedic surgeries. Methods: We studied 60 ASA l & ll patients undergoing upper limb orthopaedic surgeries including fracture humerus and fracture radius and ulna under supra clavicular achial plexus block done by paresthesia technique. . Patients were randomly allocated to three groups. Group A :( n-20) – 30 ml 0.33% bupivacaine + dexmedetomidine 50mcg.Group B :( n-20) – 30ml 0.33% bupivacaine + dexmedetomidine 75mcg.Group C: (n-20) – 30ml 0.33% bupivacaine + dexmedetomidine 100mcg. Patients were evaluated for sensory & motor block onset and duration, duration of analgesia, sedation score, complications, hemodynamic parameters including non-invasive blood pressure, pulse rate , saturation intra operatively and post operatively. Results: Sensory block onset was longer in group A (16.3�3.31) than group B(12.4�2.5) which is longer than group C (7.35�1) and motor block onset also longer in group A (20.4�2.7) than group B (16.15�2.89) which is longer than group C(12.15�2.81). The duration of both sensory and motor block was longest with group C (sensory mean 722.5�55.1minutes, motor mean 704�41.4minutes) compared with group B (sensory mean 625.5�72.7 minutes , motor mean 604�98.6 minutes) which is longer than group A (sensory mean 432�69.8minutes, motor mean 426.5�81.8). The mean duration of analgesia was dose dependent (tableB5) with C (736�67.1) >B (642�76.5) > A(480.5�81.3)minutes. Conclusion: We conclude that dexmedetomidine 100μg is an optimal dose to provide prolonged post-operative analgesia without significant side effects