ABSTRACT
Dexmedetomidine as an adjuvant to local anesthetics in peripheral nerve blocks has been used in only a few studies. We aimed at assessing the effect of dexmedetomidine as an adjuvant to ropivacaine in supraclavicular brachial plexus block. Random, controlled, and triple blind. Sixty American Society of Anesthesiologist grade I and II patients of either sex scheduled for elective upper limb surgery under supraclavicular brachial plexus block were divided into three equal groups in a prospective randomized double-blind controlled manner. For block patients in Group C received 0.5% ropivacaine [30cc], 0.5% ropivacaine with 50 microg dexmedetomidine [30cc] in Group D and 0.5% ropivacaine [30cc] in Group D-IV along with intravenous infusion of 50 microg dexmedetomidine in normal saline. IBM-SPSS software version 17, Chi-square test, Mann-Whitney U-test. Demographic profile and surgical characteristics were similar in all the three groups. Sensory block and motor block onset was earlier in group D than in group D-IV and group C. The sensory block and motor block duration was also prolonged in group D when compared with group D-IV and group C. The duration of analgesia was significantly longer in group D and D-IV when compared to group C. Dexmedetomidine as an adjuvant to 0.5%ropivacaine in ultrasound guided brachial plexus block shortens the sensory as well as motor block onset time, prolongs sensory and motor block duration and also increases the duration of analgesia. The action of dexmedetomidine most probably is local rather than centrally mediated
ABSTRACT
Under regional anesthesia, geriatric patients are prone to shivering induced perioperative complications that Anesthesiologists should prevent rather than treat. We investigated the prophylactic efficacy of oral tramadol 50 mg to prevent the perioperative shivering after transurethral resection of prostate [TURP] surgery under subarachnoid blockade [SAB]. Shivering is usually overlooked in patients undergoing urological surgery under spinal anesthesia and may result in morbidity, prolonged hospital stay and increased financial burden. Use of prophylactic measures to reduce shivering in geriatric patients who undergo urological procedures could circumvent this. Oral formulation of tramadol is a universally available cost-effective drug with the minimal side-effects. Prospective, randomized, double-blinded, placebo-controlled study. A total of 80 patients who were scheduled for TURP surgery under subarachnoid block were randomly selected. Group I and II [n = 40 each] received oral tramadol 50 mg and placebo tablet respectively. After achieving subarachnoid block, the shivering, body temperature [tympanic membrane, axillary and forehead], hemodynamic parameters and arterial saturation were recorded at regular intervals. T-test, analysis of variance test, Z-test and Fisher exact test were utilized while Statistical Product and Service Solutions, IBM, Chicago [SPSS statistics [version 16.0]], software was used for analysis. Incidence of shivering was significantly less in patients who received tramadol [7.5% vs. 40%; P < 0.01]. The use of tramadol was associated with clinically inconsequential side-effects. We conclude that the use of oral tramadol 50 mg is effective as a prophylactic agent to reduce the incidence, severity and duration of perioperative shivering in patients undergoing TURP surgery under SAB