COMPARATIVE STUDY BETWEEN DEXMEDETOMIDINE AND FENTANYL AS ADJUVANT TO BUPIVACAINE IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK

Abstract

Background: This study was conducted to evaluate the effects of fentanyl and dexmedetomidine as adjuvants to bupivacaine used for supraclavicular brachial plexus block in terms of analgesia, duration of motor block, and sensory and motor block onset times.

Methods: This was a hospital-based prospective comparative study conducted among 70 patients aged 18-60 years belonging to ASA 1 or 2 undergoing upper limb orthopaedic surgeries under supraclavicular brachial plexus block at the Department of Anesthesiology, Government Medical College, Thrissur, Kerala, India, from January 2021 to December 2022 after obtaining clearance from the institutional ethics committee and written informed consent from the study participants.

Results: The statistically significant times for the onset of sensory block were 6.43 ± 1.22 min for the dexmedetomidine group and 10.3 ± 1.25 min for the fentanyl group. The statistically significant motor block onset times were 9.7 ± 0.95 minutes for the dexmedetomidine group and 12.93 ± 1.82 minutes for the fentanyl group. A statistically significant duration of motor block was seen in the dexmedetomidine group (528 ± 48.02 min) and the fentanyl group (460 ± 34.74 min). The duration of sensory block was 538.67 ± 48.62 min in the dexmedetomidine group and 487.33 ± 48.28 min in the fentanyl group, which was statistically significant. The duration of analgesia was 734 ± 34.40 min in the dexmedetomidine group and 650 ± 23.38 min in the fentanyl group, which was statistically significant.

Conclusion: Addition of dexmedetomidine to 0.5% bupivacaine in supraclavicular brachial plexus block significantly reduces the onset of sensory and motor block and prolongs the duration of sensory and motor block and the duration of analgesia compared to fentanyl with 0.5% bupivacaine.