Evaluation of effect of dexmeditomidine as an adjuvant to bupivacaine in supraclavicular brachial plexus block.

Background: Background & objectives :To study the effect of dexmeditomidine as an adjuvant to bupivacaine in brachial plexus block on onset and duration of sensory and motor block, duration of analgesia, level of sedation,perioperative hemodynamic parameters and complications. Methods: fourty patients of ASA Ι and ASA ΙΙ scheduled for upper limb surgery were included in double blind randomised comparison of inj. Dexmeditomidine and inj. Normal saline. We divided patients in two groups. Group A patients were given inj dexmeditomidine 50 microgm (0.5ml) and group B patients were given inj normal saline in brachial plexus block. We recorded time of onset and duration of sensory and motor block, level of sedation, duration of analgesia, hemodynamic changes and side effects in both groups. Results: mean time to onset of sensory block was 7.42±1.39 min in group A and 8.24± 1.35 min and that of motor block was 15.1± 2.6min in group A and 17.0± 2.9min in group B.Total duration of sensory block was 722.15±78.27min in group A and 360.62±61.7min in group B and that of motor block was 600.6± 54.46min in group A and 300.4± 54.26min in group B. Duration of analgesia was 970.36 ± 80.7 min in group A and 480±40.31 min in group B. Conclusion: addition of 50 microgm of inj dexmeditomidine to bupivacaine in brachial plexus block shortens onset and prolongs duration of sensory and motor block, prolongs duration of analgesia and decreases intraoperative requirement of sedatives.

Comparison of epidural ropivacaine and bupivacaine for lower limb surgery.

Aims and objectives: to compare efficacy, potency, onset of action, effective duration of analgesia, sensory and motor block, peri operative haemodyamic parameters and complications following epidural bupivacaine and ropivacaine. Methods and material: sixty patients of asa i and ii scheduled for lower limb surgery were included in double blind randomized comparison of epidural ropivacaine 0.75% and bupivacaine 0.5%. we divided patients in two groups. group a patients were given inj. bupivacaine 0.5% 20 ml and group b patients were given inj. ropivacaine 0.75% 20 ml via epidural route. we recorded time of onset, highest level, peak and duration for motor and sensory block along with haemodyamic changes and side effects for both drugs. Summary: mean time to initial onset of adequate level of sensory block(t10) was. 21.76±3.37 min in group a and 22.53± 3.09 min in group b(p>0.05). total duration of sensory block was 403±16.70 min in group a and 413.5±24.67 min in group b (p=0.0007). mean time to initial onset of motor block was 12.13±2.16 in group a and 14.4±3.79 min in group b(p<0.05). peak motor blockade was achieved in 30.17±3.82 min in group a and 29.97±3.27 min in group b (p>0.05). total duration of motor block was 292±21.92 min in group a and 262.5±31.03 min in group b(p 0.0007).Conclusion: ropivacaine is safer and effective alternative to bupivacaine in epidural anesthesia.