Study of effect of dexmedetomidine with levobupivacaine on the onset and duration of analgesia and anaesthesia in brachial plexus block

Abstract

Objective: To Compare the efficacy Of Dexmedetomidine as an Adjuvant to Levobupivacaine in Axillary Brachial Plexus Block in Upper Limb Surgeries. Materials and methods: Hundred patients aged 18 to 60 years, scheduled for elective orthopedic operations in the upper limb, under axillary approach of brachial plexus block were randomized to two equal groups of 50 each into Group LBD receiving 25 ml of 0.5% levobupivacaine and Dexmedetomidine(1 mcg/kg) , while group LB received 25 ml of 0.5% levobupivacaine .The primary objective was to compare duration of sensory ( post operative analgesia ) block with or without addition of Dexmedetomidine to levobupivacaine . The secondary objective was to compare the onset and duration of sensory and motor block and hemodynamic parameters following the block between the groups intraoperatively at regular intervals. Results: There is significant prolonged duration of sensory and motor blockade in group LBD compared to group LB (P<0.001). Mean duration of sensory blockade (Group LBD, 14.91±1.19 hrs and Group LB, 10.73±.888 hrs). There is significant early onset of sensory and motor block in group LBD compared to group LB (P<0.001) [Onset of sensory block (group LBD, 7.8±1.58min; group LB, 11.04±1.55 min). Onset of motor block (group LBD, 14.2 ± 2.12min; group LB, 16.14 ± 2.119 min)]. Conclusion: Dexmedetomidine 1μg/kg when added to 25mL of Levobupivacaine 0.5% for axillary brachial plexus block speeds the onset of sensory and motor blocks (P < 0.05). The combination produces improved analgesia, resulting in a prolonged effect and reduced requirements for rescue analgesics