Title: Comparison of the Effects of Fentanyl and Dexmedetomidine in Supraclavicular Brachial Plexus Block Achieved with 0.5% Bupivacaine in Karpaga Vinayaga Medical College and Hospital, Maduranthagam
Authors: Dr.P.Manohar, Dr.M.Prakash
DOI: http://dx.doi.org/10.18535/jmscr/v3i8.38
DIDS : 08.2015-XXXXXXX
Abstract
Background & Objectives: Supraclavicular block of brachial plexus provides complete and reliable anesthesia for upper limb surgeries. Bupivacaine is an effective local anesthetic for brachial plexus anesthesia. It provides good sensory and motor blockade. We evaluated the anesthetic quality and length of analgesia with the addition of either Fentanyl or Dexmedetomidine to Bupivacaine for Supraclavicular brachial plexus block.
Methods: In a prospective clinical trial, 90 patients were randomly allocated to either receive 30 ml Bupivacaine 0.5% (Group B), 30 ml Bupivacaine 0.5% with Fentanyl 50 mcg (Group BF) or 30 ml Bupivacaine 0.5% with Dexmedetomidine 50 mcg (Group BD) in Supraclavicular brachial plexus. The characteristics for anesthesia and analgesia were assessed for the three groups.
Observations: Demographic profile was comparable in the groups. The onset of analgesia and time to complete analgesia was enhanced in Group BD and Group BF compared to Group B. Prolongation of sensory blockade and motor blockade with extended duration of postoperative analgesia was observed in Group BD and Group BF compared to Group B. There were minimum hemodynamic disturbances and side-effects in any group except for Grade 3 sedation score which was frequently noted in patients receiving Dexmedetomidine as adjunct.
Results: Compared to the use of Bupivacaine 0.5%, 30 ml alone for supraclavicular brachial plexus block, the addition of 50 mcg Fentanyl or 50 mcg Dexmedetomidine to Bupivacaine enhanced onset of block and also increased duration of surgical anesthesia with prolongation of post-operative analgesia. Furthermore blockade characteristics improved better with addition of Dexmedetomidine than Fentanyl without increasing incidence of unwanted side-effects.
Keywords: Supraclavicular brachial plexus block, Bupivacaine, Fentanyl and Dexmedetomidine.
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