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Comparison of dexmedetomidine and epinephrine as an adjuvant to 1% mepivacaine in brachial plexus block

BACKGROUND: Dexmedetomidine extends the duration of nerve block when administered perineurally together with local anesthetics by central and/or peripheral action. In this study, we compared the duration of nerve block between dexmedetomidine and epinephrine as an adjuvant to 1% mepivacaine in infra...

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Autores principales: Song, Jang-Ho, Shim, Hee Yong, Lee, Tong Joo, Jung, Jong-Kwon, Cha, Young-Deog, Lee, Doo Ik, Kim, Gun Woo, Han, Jeong Uk
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Anesthesiologists 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4028555/
https://www.ncbi.nlm.nih.gov/pubmed/24851163
http://dx.doi.org/10.4097/kjae.2014.66.4.283
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author Song, Jang-Ho
Shim, Hee Yong
Lee, Tong Joo
Jung, Jong-Kwon
Cha, Young-Deog
Lee, Doo Ik
Kim, Gun Woo
Han, Jeong Uk
author_facet Song, Jang-Ho
Shim, Hee Yong
Lee, Tong Joo
Jung, Jong-Kwon
Cha, Young-Deog
Lee, Doo Ik
Kim, Gun Woo
Han, Jeong Uk
author_sort Song, Jang-Ho
collection PubMed
description BACKGROUND: Dexmedetomidine extends the duration of nerve block when administered perineurally together with local anesthetics by central and/or peripheral action. In this study, we compared the duration of nerve block between dexmedetomidine and epinephrine as an adjuvant to 1% mepivacaine in infraclavicular brachial plexus block. METHODS: Thirty patients, scheduled for upper limb surgery were assigned randomly to 3 groups of 10 patients each. We performed brachial plexus block using a nerve stimulator. In the control group (group C), patients received 40 ml of 1% mepivacaine. In group E, patients received 40 ml of 1% mepivacaine containing 200 µg of epinephrine as an adjuvant. In group D, patients received 40 ml of 1% mepivacaine containing 1 µg/kg of dexmedetomidine as an adjuvant. Sensory block duration, motor block duration, time to sense pain, and onset time were assessed. We also monitored blood pressure, heart rate, oxygen saturation and bispectral index. RESULTS: In group D and group E, sensory block duration, motor block duration and time to sense first pain were prolonged significantly compared to group C. However, there was no significant difference between group D and group E. CONCLUSIONS: Perineural 1 µg/kg of dexmedetomidine similarly prolonged nerve block duration compared to 200 µg of epinephrine, but slowed heart rate. Thus, dexmedetomidine is expected to be a good alternative as an adjuvant to local anesthesia in patients who are cautioned against epinephrine.
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spelling pubmed-40285552014-05-21 Comparison of dexmedetomidine and epinephrine as an adjuvant to 1% mepivacaine in brachial plexus block Song, Jang-Ho Shim, Hee Yong Lee, Tong Joo Jung, Jong-Kwon Cha, Young-Deog Lee, Doo Ik Kim, Gun Woo Han, Jeong Uk Korean J Anesthesiol Clinical Research Article BACKGROUND: Dexmedetomidine extends the duration of nerve block when administered perineurally together with local anesthetics by central and/or peripheral action. In this study, we compared the duration of nerve block between dexmedetomidine and epinephrine as an adjuvant to 1% mepivacaine in infraclavicular brachial plexus block. METHODS: Thirty patients, scheduled for upper limb surgery were assigned randomly to 3 groups of 10 patients each. We performed brachial plexus block using a nerve stimulator. In the control group (group C), patients received 40 ml of 1% mepivacaine. In group E, patients received 40 ml of 1% mepivacaine containing 200 µg of epinephrine as an adjuvant. In group D, patients received 40 ml of 1% mepivacaine containing 1 µg/kg of dexmedetomidine as an adjuvant. Sensory block duration, motor block duration, time to sense pain, and onset time were assessed. We also monitored blood pressure, heart rate, oxygen saturation and bispectral index. RESULTS: In group D and group E, sensory block duration, motor block duration and time to sense first pain were prolonged significantly compared to group C. However, there was no significant difference between group D and group E. CONCLUSIONS: Perineural 1 µg/kg of dexmedetomidine similarly prolonged nerve block duration compared to 200 µg of epinephrine, but slowed heart rate. Thus, dexmedetomidine is expected to be a good alternative as an adjuvant to local anesthesia in patients who are cautioned against epinephrine. The Korean Society of Anesthesiologists 2014-04 2014-04-28 /pmc/articles/PMC4028555/ /pubmed/24851163 http://dx.doi.org/10.4097/kjae.2014.66.4.283 Text en Copyright © the Korean Society of Anesthesiologists, 2014 http://creativecommons.org/licenses/by-nc/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Research Article
Song, Jang-Ho
Shim, Hee Yong
Lee, Tong Joo
Jung, Jong-Kwon
Cha, Young-Deog
Lee, Doo Ik
Kim, Gun Woo
Han, Jeong Uk
Comparison of dexmedetomidine and epinephrine as an adjuvant to 1% mepivacaine in brachial plexus block
title Comparison of dexmedetomidine and epinephrine as an adjuvant to 1% mepivacaine in brachial plexus block
title_full Comparison of dexmedetomidine and epinephrine as an adjuvant to 1% mepivacaine in brachial plexus block
title_fullStr Comparison of dexmedetomidine and epinephrine as an adjuvant to 1% mepivacaine in brachial plexus block
title_full_unstemmed Comparison of dexmedetomidine and epinephrine as an adjuvant to 1% mepivacaine in brachial plexus block
title_short Comparison of dexmedetomidine and epinephrine as an adjuvant to 1% mepivacaine in brachial plexus block
title_sort comparison of dexmedetomidine and epinephrine as an adjuvant to 1% mepivacaine in brachial plexus block
topic Clinical Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4028555/
https://www.ncbi.nlm.nih.gov/pubmed/24851163
http://dx.doi.org/10.4097/kjae.2014.66.4.283
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