Dexamethasone compared with dexmedetomidine as an adjuvant to ropivacaine for supraclavicular brachial plexus block: a prospective randomized clinical trial
Keywords:
dexamethasone, dexmedetomidine, ropivacaine, supraclavicular brachial plexus blockAbstract
Introduction: The objective of our study was to compare the anesthetic and analgesic effect of dexamethasone with that of dexmedetomidine as an adjuvant to ropivacaine for supraclavicular brachial plexus block.
Methodology: In this prospective randomized double blind clinical trial, 120 patients aged 18 to 65 years undergoing upper limb surgery under supraclavicular brachial plexus block were randomized to receive either- Group A- 1 mL normal saline, group B- 1 mL (4 mg) dexamethasone or group C- 1 mL (50 mcg) dexmedetomidine, added to 20 mL 0.5% ropivacaine for the block. Primary outcomes were onset of sensory and motor block and duration of analgesia. Secondary outcomes were duration of block and side effects.
Results: Onset of sensory block in median (IQR) was 9 min (3-39 min) in group A, 12 min (3-45 min) in group B and 9 min (3-21 min) in group C (p= 0.26). Onset of motor block was 10.5 min (3-45 min) in group A, 12 min (3-45 min) in group B and 12 min (3-45 min) in group C (p= 0.93). Duration of analgesia was 9 h (3-24 h), 9 hr (2.5-24 h) and 9.37 hr (4-24 h) in groups A, B and C respectively (p= 0.75). Secondary outcomes were comparable except sedation which was more in group C. (p=0.001)
Conclusion: There is no difference in the anesthetic and analgesic effects of dexamethasone compared with dexmedetomidine added as an adjuvant to ropivacaine for supraclavicular brachial plexus block but dexmedetomidine can cause increased incidence of sedation.
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