Volume : IX, Issue : IV, April - 2020

COMPARATIVE EVALUATION OF DEXMEDETOMIDINE V/S NITROGLYCERINE WITH LIGNOCAINE IN BIER'S BLOCK FOR UPPER LIMB ORTHOPAEDIC SURGERIES

Dr. Amar Parkash, Dr. Anu Sharma, Dr. Leena Mahajan, Dr. Shweta Munjal

Abstract :

The analgesic effect of Dexmedetomidine and Nitroglycerine was evaluated when added to lidocaine in intravenous regional anaesthesia. We randomly assigned sixty patients undergoing upper limb orthopaedic surgeries into two groups, one of them receiving 1µg/kg dexmedetomidine and the other one receiving 200 µg nitroglycerine alongwith 0.5% lidocaine to total volume of 40 ml. Haemodynamic variables, VAS scores and analgesic requirements were recorded during the surgeries. After the tourniquet deflation, VAS score, time to first analgesic requirement, total analgesic consumption in the first 24 hours after surgery were recorded. Shortened sensory and motor block onset times were seen in nitroglycerine group (3.38±0.70 and 5.32±1.02 minutes respectively) as compared to dexmedetomidine group (4.50±0.91 and 8.18±1.53 minutes respectively) (p<0.05). Shortened VAS scores of tourniquet pain (p<0.05) and improved quality of anaesthesia were found in group LD (dexmedetomidine) (p<0.05). VAS scores were lower in group dexmedetomidine after tourniquet release and in the postoperative period (p<0.05). Postoperative analgesic requirements were significantly smaller in group LD (p<0.05). Mean duration of analgesia was longer in LD group (7.07±2.14 hours) as compared to LN (nitroglycerine) group (2.93±0.86 hours) (p<0.05). The sedation score was equal in both the groups in intraoperative period, however in the postoperative period, the median sedation score at 15 min and 30 min was higher in dexmedetomidine group as compared to nitroglycerine group (p<0.05). Surgeon satisfaction score in both the groups was equal, however the patient satisfaction score was significantly better in dexmedetomidine group (p<0.05). Hence, we conclude that dexmedetomidine group was accompanied by longer duration of analgesia and provides better quality of anaesthesia. Nitroglycerine group showed more rapid onset of sensory as well as motor blockade. In addition, dexmedetomidine group was associated with short–lived sedation in immediate postoperative period

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Article: Download PDF    DOI : 10.36106/ijsr  

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COMPARATIVE EVALUATION OF DEXMEDETOMIDINE V/S NITROGLYCERINE WITH LIGNOCAINE IN BIER'S BLOCK FOR UPPER LIMB ORTHOPAEDIC SURGERIES, Dr. Amar Parkash, Dr. Anu Sharma, Dr. Leena Mahajan, Dr. Shweta Munjal INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH : Volume-9 | Issue-4 | April-2020

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