A comparative study of dexmedetomidine and verapamil as adjunct to local anaesthetic solution on the onset, quality and duration of brachial plexus block.

Volume : VII, Issue : IV, April - 2018

Dr. Ved Prakash Pandey, Dr. Irfan Rasool Bhat, Dr. Arun Kumar Gupta, Dr. Luxmi Shankar Mishra

Background: Alpha 2 agonists , Calcium channel blockers and many other adjuvants potentiate the effects of local anaesthetics. We compared the

effect of dexmedetomidine and verapamil as adjuvant to local anaesthetic solution on the onset, quality and duration of achial plexus block in

patients undergoing routine upper extremity surgery.

Aims: The study is aimed to perform and demonstrate the comparative effect of dexmedetomidine and verapamil as adjuvant added to 0.5%

bupivacaine for supraclavicular achial plexus block.

Methods and Material: The study was a prospective, randomized, controlled, double blinded study. 120 patients undergoing elective upper limb

surgery were divided into three groups of 40 each. Group B received 30 ml of 0.5% bupivacaine, Group D received 30 ml of 0.5% bupivacaine with

100 μg dexmedetomidine added to it and Group V received 30 ml of 0.5% bupivacaine with 2.5 mg verapamil added to it.

Statistical analysis used: Microsoft Excel 2007 and statistical software plug–ins, Chi–square test and student t–test (Unpaired and One way

ANOVA).Data are being represented as mean � SD. A ‘p‘ value of <0.05 was considered significant.

Results: Onset of sensory blockade time was fastest in Group D(11.3 � 1.38 minutes),marginally faster in Group V(18.1 � 1.24 minutes) as

compared to Group B(18.55 � 1.78 minutes)(p<0.05).Onset of motor blockade time was fastest in Group D(14.2 � 1.24 minutes),marginally

faster in Group V(20.55 � 1.54 minutes) as compared to Group B(21.05 � 2.09 minutes)(p<0.05).Quality of sensory blockade was better in Group

D(max VAS score 1.52 � 0.67) as compared to Group V(max VAS score 1.9 � 0.8) and Group B(max VAS score 2.05 � 0.77)(p<0.05).Duration of

motor blockade was longer in Group D(9.61 � 1.51 hrs) as compared to Group V(5.58 � 0.87 hrs) and Group B(5.42 � 0.86 hrs)(p<0.05).Duration

of analgesia was much prolonged in Group D(14.42 � 2.49 hrs.) as compared to Group V(8.61 � 1.96 hrs.) and Group B(8.27 � 1.82 hrs.)(p<0.05).

Conclusions: Addition of dexmedetomidine to bupivacaine in supraclavicular achial plexus block produces early onset, better quality of block,

and prolonged pain free post – operative period without increasing the side effects or complications, while addition of verapamil to bupivacaine

does not produce any significant difference in block characteristics.