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A Comparative Study of Effect of 0.25% Levobupivacaine with Dexmedetomidine versus 0.25% Levobupivacaine in Ultrasound-Guided Supraclavicular Brachial Plexus Block

CONTEXT: Dexmedetomidine, an α(2)-agonist, has been studied widely as an adjuvant to local anesthetics in regional anesthesia techniques to enhance the quality and duration of analgesia (DOA). It was hypothesized that addition of dexmedetomidine 0.5 ug.kg(‒1) to levobupivacaine would prolong the DOA...

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Autores principales: Iyer, Lakshmi S., Bhat, Shreyas S., Nethra, H.N, Vijayakumar, H.N, Sudheesh, K, Ramachandriah
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9004279/
https://www.ncbi.nlm.nih.gov/pubmed/35422557
http://dx.doi.org/10.4103/aer.aer_145_21
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author Iyer, Lakshmi S.
Bhat, Shreyas S.
Nethra, H.N
Vijayakumar, H.N
Sudheesh, K
Ramachandriah,
author_facet Iyer, Lakshmi S.
Bhat, Shreyas S.
Nethra, H.N
Vijayakumar, H.N
Sudheesh, K
Ramachandriah,
author_sort Iyer, Lakshmi S.
collection PubMed
description CONTEXT: Dexmedetomidine, an α(2)-agonist, has been studied widely as an adjuvant to local anesthetics in regional anesthesia techniques to enhance the quality and duration of analgesia (DOA). It was hypothesized that addition of dexmedetomidine 0.5 ug.kg(‒1) to levobupivacaine would prolong the DOA. AIMS: We aimed to evaluate the efficacy of dexmedetomidine as an adjuvant to levobupivacaine in supraclavicular brachial plexus block with respect to onset and duration of sensory and motor blockade, and duration of analgesia. SETTINGS AND DESIGN: This was a prospective randomized double-blind study carried out at a tertiary hospital attached to medical college. SUBJECTS AND METHODS: Sixty American Society of Anesthesiologists PS Class I and II patients aged between 18 and 60 years of either sex, undergoing elective upper-limb surgery lasting more than 30 min, were included in the study. They were randomly divided into two groups of thirty each to receive ultrasound-guided supraclavicular brachial plexus block. Group L was given nerve block with 20 mL of 0.25% levobupivacaine and 1 mL saline, and Group D received 20 mL of 0.25% levobupivacaine with 0.5 ug.kg(‒1) of dexmedetomidine (diluted to volume of 1 mL). Onset time and duration of sensory and motor blockade, time to first rescue analgesia, and hemodynamic parameters were recorded. STATISTICAL ANALYSIS USED: Chi-square test for qualitative variables and Student's unpaired “t“ test for continuous variables were used for statistical analysis. RESULTS: The onset of sensory and motor blockade was 6.51 ± 0.77 min and 10.71 ± 0.34 min in Group D and 9.9 ± 0.45 and 15.93 ± 1.92 min in Group L, respectively (P < 0.005). DOA was 9.53 ± 0.29 h in Group D and 3.89 ± 0.30 h in Group L (P < 0.001). The duration of sensory and motor block was 9.14 ± 0.19 h and 8.55 ± 0.31 h in Group D and 6.15 ± 3.02 and 5.61 ± 2.98 h in Group L, respectively (P < 0.005). No adverse effects were observed in either of the groups. CONCLUSIONS: Addition of 0.5 ug.kg(‒1) of dexmedetomidine to 20 mL 0.25% levobupivacaine in ultrasound guided (USG)-guided supraclavicular brachial plexus block shortens the onset time of sensory and motor blockade and prolongs duration of sensory and motor block and DOA.
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spelling pubmed-90042792022-04-13 A Comparative Study of Effect of 0.25% Levobupivacaine with Dexmedetomidine versus 0.25% Levobupivacaine in Ultrasound-Guided Supraclavicular Brachial Plexus Block Iyer, Lakshmi S. Bhat, Shreyas S. Nethra, H.N Vijayakumar, H.N Sudheesh, K Ramachandriah, Anesth Essays Res Original Article CONTEXT: Dexmedetomidine, an α(2)-agonist, has been studied widely as an adjuvant to local anesthetics in regional anesthesia techniques to enhance the quality and duration of analgesia (DOA). It was hypothesized that addition of dexmedetomidine 0.5 ug.kg(‒1) to levobupivacaine would prolong the DOA. AIMS: We aimed to evaluate the efficacy of dexmedetomidine as an adjuvant to levobupivacaine in supraclavicular brachial plexus block with respect to onset and duration of sensory and motor blockade, and duration of analgesia. SETTINGS AND DESIGN: This was a prospective randomized double-blind study carried out at a tertiary hospital attached to medical college. SUBJECTS AND METHODS: Sixty American Society of Anesthesiologists PS Class I and II patients aged between 18 and 60 years of either sex, undergoing elective upper-limb surgery lasting more than 30 min, were included in the study. They were randomly divided into two groups of thirty each to receive ultrasound-guided supraclavicular brachial plexus block. Group L was given nerve block with 20 mL of 0.25% levobupivacaine and 1 mL saline, and Group D received 20 mL of 0.25% levobupivacaine with 0.5 ug.kg(‒1) of dexmedetomidine (diluted to volume of 1 mL). Onset time and duration of sensory and motor blockade, time to first rescue analgesia, and hemodynamic parameters were recorded. STATISTICAL ANALYSIS USED: Chi-square test for qualitative variables and Student's unpaired “t“ test for continuous variables were used for statistical analysis. RESULTS: The onset of sensory and motor blockade was 6.51 ± 0.77 min and 10.71 ± 0.34 min in Group D and 9.9 ± 0.45 and 15.93 ± 1.92 min in Group L, respectively (P < 0.005). DOA was 9.53 ± 0.29 h in Group D and 3.89 ± 0.30 h in Group L (P < 0.001). The duration of sensory and motor block was 9.14 ± 0.19 h and 8.55 ± 0.31 h in Group D and 6.15 ± 3.02 and 5.61 ± 2.98 h in Group L, respectively (P < 0.005). No adverse effects were observed in either of the groups. CONCLUSIONS: Addition of 0.5 ug.kg(‒1) of dexmedetomidine to 20 mL 0.25% levobupivacaine in ultrasound guided (USG)-guided supraclavicular brachial plexus block shortens the onset time of sensory and motor blockade and prolongs duration of sensory and motor block and DOA. Wolters Kluwer - Medknow 2021 2022-03-30 /pmc/articles/PMC9004279/ /pubmed/35422557 http://dx.doi.org/10.4103/aer.aer_145_21 Text en Copyright: © 2022 Anesthesia: Essays and Researches https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Iyer, Lakshmi S.
Bhat, Shreyas S.
Nethra, H.N
Vijayakumar, H.N
Sudheesh, K
Ramachandriah,
A Comparative Study of Effect of 0.25% Levobupivacaine with Dexmedetomidine versus 0.25% Levobupivacaine in Ultrasound-Guided Supraclavicular Brachial Plexus Block
title A Comparative Study of Effect of 0.25% Levobupivacaine with Dexmedetomidine versus 0.25% Levobupivacaine in Ultrasound-Guided Supraclavicular Brachial Plexus Block
title_full A Comparative Study of Effect of 0.25% Levobupivacaine with Dexmedetomidine versus 0.25% Levobupivacaine in Ultrasound-Guided Supraclavicular Brachial Plexus Block
title_fullStr A Comparative Study of Effect of 0.25% Levobupivacaine with Dexmedetomidine versus 0.25% Levobupivacaine in Ultrasound-Guided Supraclavicular Brachial Plexus Block
title_full_unstemmed A Comparative Study of Effect of 0.25% Levobupivacaine with Dexmedetomidine versus 0.25% Levobupivacaine in Ultrasound-Guided Supraclavicular Brachial Plexus Block
title_short A Comparative Study of Effect of 0.25% Levobupivacaine with Dexmedetomidine versus 0.25% Levobupivacaine in Ultrasound-Guided Supraclavicular Brachial Plexus Block
title_sort comparative study of effect of 0.25% levobupivacaine with dexmedetomidine versus 0.25% levobupivacaine in ultrasound-guided supraclavicular brachial plexus block
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9004279/
https://www.ncbi.nlm.nih.gov/pubmed/35422557
http://dx.doi.org/10.4103/aer.aer_145_21
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