A COMPARATIVE STUDY OF EFFICACY OF TWO DOSES OF DEXMEDETOMIDINE AS ADJUVANT TO ROPIVACAINE IN ULTRASOUND- GUIDED AXILLARY BRACHIAL PLEXUS BLOCK FOR ELECTIVE FOREARM SURGERIES – A PROSPECTIVE DOUBLE-BLIND RANDOMIZED CONTROLLED TRIAL

Abstract

Background: Perioperative and postoperative pain control is one of the most challenging issues. Despite innovations in the field of anesthesia and surgery, postoperative pain is an inevitable problem1,2. Objective: to compare the two dosages of dexmedetomidine as an adjuvant with 0.75% ropivacaine to obtain optimal analgesia with minimum side effects. Methods: This Prospective double-blinded randomized controlled trial was conducted among patients of all sexes coming to Central Hospital South Eastern Railway Hospital, Kolkata for elective upper limb surgeries during the study period 1 year (December 2023 to November 2024). Result: Both the onset of sensory and motor blockade were also significantly prolonged with higher doses of dexmedetomidine at p<0.05. The onset of sensory block of Group A and Group B were 9.68±1.59 min and 6.50±1.14 min respectively. The onset of motor block in Group A was 12.5±1.44 min and in Group B was 8.68±1.04 min. Duration of sensory block was prolonged in a higher dose of dexmedetomidine (Group A-1µg/kg dexmedetomidine vs Group B-2µg/kg dexmedetomidine: 756.14±111.43 min vs 884.09±93.49 min, p<0.001). Duration of motor block was also significantly prolonged in Group B than in Group A (Group A-1µg dexmedetomidine vs Group B-2µg dexmedetomidine: 848.41±89.67 min vs 909.55±87.78 min, p=0.027). Conclusion: Even though the higher dose of dexmedetomidine improves block characteristics, 1µg/kg dose of dexmedetomidine can be considered the optimal dose as adjuvant to ropivacaine considering the minimal hemodynamic instability in peripheral nerve block.