ABSTRACT
Background: This study was conducted to compare the three technique Conventional blind, Nerve stimulator guided and Ultrasound guided for Interscalene brachial plexus block in surgeries of upper limb. Methods: Total 60 patients were included in our study which were randomly allotted by closed envelope technique into either of the three groups namely Conventional blind (group CB), US-guided (group US) or NS-guided (group NS). The drug bupivacaine 0.5% (2 mg/kg) was used and diluted with normal saline to make a total volume of 30 ml. Results: Comparison between the Conventional blind (CB), Nerve Stimulator (NS) and Ultrasound guided (US) technique of interscalene brachial plexus block revealed that the block execution time, time of onset of sensory and motor block was significantly less in ultrasound group as compare to other groups. The mean duration of analgesia too, was significantly higher in both NS and US group (3 hr & 23 min ,3 hrs 30 min respectively), while it was 2 hr 47 min in CB group. The incidence of patchy effect (3 cases) and blockade failure requiring general anesthesia (4 cases) were significantly higher in CB group compared to NS group (2 cases each) and US group (1 case each). Conclusion: The success rate and effective quality of the block were more satisfactory with ultrasound technique than the nerve stimulator or conventional blind technique.
ABSTRACT
Background: Duration of action of local anaesthetic is an important limiting factor in spinal anaesthesia. Dexmedetomidine, selective α 2- agonist has been recently used in addition to other adjuvants to prolong the duration of intrathecal local anaesthetics. Aim: To compare two different doses of dexmedetomidine added to heavy bupivacaine 0.5% intrathecally for femur surgeries. Methods: In this prospective double blind trial, one hundred and twenty patients were randomly allocated into two groups, D1 and D2. Group D1 received 12.5 mg 0.5% hyperbaric bupivacaine and 5 μg dexmedetomidine. Group D2 received 12.5 mg 0.5% hyperbaric bupivacaine and 10 μg dexmedetomidine. Results: Sensory and motor block were comparable in both groups in terms of characteristics like the highest level of sensory block achieved, time to achieve maximum sensory block and time of two segment regression, time to achieve maximal motor block and duration of regression to Bromage scale 0. However time of first analgesic request and total analgesic requirement were significantly reduced by increasing intrathecal dose of dexmedetomidine to 10 μg without any undesirable effects. Conclusion: Intrathecal dose of 10 μg dexmedetomidine provided an increased duration of sensory compared to 5μg dosing, with no significant increase in duration of motor blockade or the incidence of hypotension, bradycardia and any other undesirable side-effects.