Vol. 7, Issue 2, Part A (2025)

Background: An effective nerve block with longer duration and quicker onset is produced by clinical use of adjuvants along with local anesthetic. Now-a-days, brachial plexus blocks are frequently performed on patients having forearm and hand surgeries. This study investigates 0.75% ropivacaine with dexmedetomidine and dexamethasone as adjuvants in ultrasound-guided supraclavicular brachial plexus blocks for forearm and hand surgeries.
Materials and Methods: The study included 60 individuals who were allocated for forearm and hand surgeries and randomly divided into Group A (received 20ml of 0.75% ropivacaine along with 50 mcg of dexmedetomidine) and Group B (received 20ml of 0.75% ropivacaine and 8 mg of dexamethasone) for single-shot supraclavicular brachial plexus block performed under ultrasound guidance. Outcomes were evaluated. Statistical significance analysis was performed utilizing SPSS software, with P-value threshold set at less than 0.05.
Results: Results show that, there was no notable difference concerning age, gender, weight, ASA grading and hemodynamic variables between 2 groups. It was also observed that, average onset of sensory and motor block was quicker in group A (10±2.6 and 17.6±2.58 minutes) than group B (14±4.1 and 24±3.99 minutes). The average duration of sensory and motor block was extended in group A (18±4.1 and 17±2.8 hours) unlike group B (16±2.6 and 15±2.6 hours). The duration of analgesia was also longer in group A (19.6±2.81 hours) than in group B (17±2.52 hours). Mean sedation score at 3 hours was higher in group A (2.1±0.3 hours) than group B (1.7±0.4 hours). The occurrence of bradycardia was observed in merely 2 patients from group A.
Conclusion: We found that addition of dexmedetomidine with 0.75% ropivacaine in brachial plexus causes rapid onset and prolongs the duration of both sensory and motor block and prolongs the duration of analgesia, with stable hemodynamics and with minimal or negligible side effects compared to dexamethasone.