Evaluation of the Effects of Dexamethasone and Dexme-detomidine as Adjuvants to Bupivacaine in Supraclavicular Brachial Plexus Block in Upper Limb Surgeries

Abstract

Background:Supraclavicular nerve block is good alternative to general anesthesia for upper limb surgeries. Aim: This study aimed to compare the efficacy of bupivacaine plus dexamethasone versus bupivacaine plus dexmedetomidine as adjuvants on supraclavicular brachial plexus block characteristics including onset and duration of sensory and motor blockade, duration of postoperative analgesia and sedation score. Patients and Methods:This prospective, randomized, single-blind study was carried out on 44 patients with American Society of Anesthesiologists (ASA) grades I, II, III and IV, aged 18 to 60 years, of both sex, BMI less than 36 Kg/M2 and who scheduled for upper limb orthopedic surgeries, vascular surgeries and plastic surgeries. Patients were divided into two groups: Group I: 20 ml bupivacaine 0.5%+4mg dexamethasone. Group II: 20 ml bupivacaine 0.5%+ dexmedetomidine 1 μg/kg. Results: Data was collected via a data collection sheet. In both groups the adjuvants prolonged duration of analgesia postoperative; however, dexamethasone decreased post operative opioids consumption up to 36 hours. Conclusion: Regarding comparison between dexmedetomidine and dexamethasone as an adjuvant to bupivacaine in ultrasound guided supraclavicular block, it could be concluded that the addition of dexamethasone to bupivacaine prolong the time of block and analgesia duration longer than dexmedetomidine.Both dexmedetomidine and dexamethasone have individually been shown to be beneficial as an adjuvant to bupivacaine