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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Corresponding Author

Dr.P.Manohar

Assistant Professor, Department of Anesthesia,

Karpaga Vinayaga Medical College Aad Hospital, Maduranthagam

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