Comparison Of Efficacy Of Levobupivacaine And Levobupivacaine With Dexmedetomidine For Supraclavicular Brachial Plexus Block In Patients Undergoing Upperlimb Surgeries – A One Year Randomised Controlled Trial

Abstract

INTRODUCTION: Supraclavicular approach to brachial plexus block provides the most effective regional anaesthesic technique for surgeries of upper extremity. Levobupivacaine has strongly emerged as a safer alternative to the commonly used bupivacaine for regional anesthesia. Among the various adjuvants, alpha 2 agonists like dexmedetomidine combined with local anaesthetics improve the quality of regional anesthesia. AIMS AND OBJECTIVES: This study was conducted to compare the onset and duration of sensory and motor blockade and duration of analgesia along with changes in Heart rate, Systolic Blood Pressure and Diastolic Blood Pressure following administration of either levobupivacaine or levobupivacaine – dexmedetomidine for supraclavicular brachial plexus block in patients undergoing upper limb surgeries. MATERIALS AND METHODS: This prospective randomised controlled study was carried out in the Department of Anaesthesiology at KLE’S Dr. Prabhakar Kore Hospital and Medical Research Centre, Nehru nagar, Belagavi which included 50 ASA grade I and II patients between the ages of 18 and 60 years who underwent elective upper limb surgeries. After obtaining ethical committee clearance and informed consent, the patients were randomly allocated into two groups of 25 each by computer generated table to recieve 39 ml of 0.5% levobupivacaine and 1ml (100mcgs) of dexmedetomidine in Group LD and 39 ml of 0.5% levobupivacaine and 1 ml of normal saline in Group LS. The onset, duration of sensory and motor blockade and duration of analgesia were observed between the groups. RESULTS: The onset of sensory and motor blockade was faster in Group LD when compared to Group LS (p <0.001). The duration of sensory and motor blockade was longer in Group LD when compared to Group LS (p <0.001). The mean duration of analgesia was significantly longer in Group LD compared to Group LS (p <0.001). Group LD also had a better hemodynamic stability than Group LS in the intraoperative period. CONCLUSION: Dexmedetomidine when added to levobupivacaine in supraclavicular brachial plexus block shortens the onset time, prolongs the duration of sensory and motor blockade as well as the duration of analgesia without any systemic side effects.