Comparative Study of Intravenous Dexmedetomidine Sedation With Perineural Dexmedetomidine on Supraclavicular Approach Brachial Plexus Block in Upper Limb Orthopaedic Surgery
| Autor: | Sarla Pandya, Priyank Samar, Tanvi A Dhawale |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Sedation Hemodynamics 030204 cardiovascular system & hematology upper limb surgery Loading dose 03 medical and health sciences 0302 clinical medicine Anesthesiology Medicine Dexmedetomidine Brachial plexus block Bupivacaine supraclavicular block business.industry General Engineering bupivacaine dexmedetomidine medicine.anatomical_structure Anesthesia Orthopedic surgery Upper limb lignocaine medicine.symptom business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Cureus |
| ISSN: | 2168-8184 |
| Popis: | Background Dexmedetomidine is being used as an adjuvant analgesic, both as intravenous (IV) and intrathecal infusion. The role of perineural (P) dexmedetomidine has evoked attention recently. The aim of this study was to compare the effect of IV dexmedetomidine and P dexmedetomidine as an adjunct to supraclavicular brachial plexus block in upper limb orthopaedic surgery. Methods Patients were randomly divided into two equal groups (n=20). Group I (IV dexmedetomidine) received dexmedetomidine 1 mcg/kg IV as loading dose over 10 minutes, followed by continuous infusion of dexmedetomidine 0.4 mcg/kg/hr IV. Group P (P dexmedetomidine) received dexmedetomidine at 1 mcg/kg perineurally. After adequate motor response with the aid of peripheral nerve stimulator a supraclavicular block with 40 ml solution containing 5 mg/kg lignocaine (2%) with adrenaline (1:200,000) and 2 mg/kg of bupivacaine (0.5%) was injected to both the groups. Group P also received dexmedetomidine perineurally with block. Onset and duration of sensory and motor block, Ramsay sedation score, hemodynamic parameters, and postoperative analgesia requirement were assessed along with side effects. The data obtained were recorded as mean ± SD, ranges, numbers, and ratios. Results were analyzed using the chi-square test, the Mann-Whitney test for non-parametric data, and an unpaired ‘t’-test for parametric data. Statistical analysis was carried out using the SPSS (version 10, 2002; SPSS Inc., Chicago, IL, USA) for Windows statistical package. P value less than 0.05 was considered statistically significant. Results Mean onset of sensory block was earlier in group I than in group P (p0.05). Duration of sensory and motor blockade was longer in group I (p4) was higher in group I (p>0.05). Conclusion IV dexmedetomidine produced early onset of sensory block, longer duration of sensory and motor block, and longer duration of analgesia as compared with P dexmedetomidine as an adjuvant to supraclavicular block with 5 mg/kg lignocaine (2%) and 2 mg/kg bupivacaine (0.5%) in upper limb orthopaedic surgeries. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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