COMPARATIVE EVALUATION OF DEXMEDETOMIDINE AND HYALURONIDASE AS ADJUVANT TO 0.5% BUPIVACAINE PLAIN IN LANDMARK GUIDED SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK FOR UPPER LIMB SURGERIES

Abstract

Background and Aims:

Various additives are mixed with local anaesthetic agents to increase the quality of block in regional anaesthesia. We compared Dexmedetomidine and Hyaluronidase as an adjunct to bupivacaine (0.5%) in supraclavicular brachial plexus block with respect to the onset and duration of sensory and motor block and duration of analgesia.

Material and Methods:

Sixty American Society of Anaesthesiologists Grades I and II patients scheduled for various orthopaedic surgeries of the upper limb under supraclavicular brachial plexus block were divided into two equal groups in a randomized, double-blind manner. Patients were assigned randomly to one of the two groups. In Group D (n = 30), 10 ml of 0.5% bupivacaine plus 1 ml (100 μg) Dexmedetomidine and in Group H (n = 30), 10 ml of 0.5% bupivacaine plus 1 ml (150 IU) hyaluronidase were given. The onset and duration of sensory and motor block, duration of analgesia, and quality of anaesthesia were studied in both the groups.

Results:

There was statistically significant difference in the onset of sensory and motor block in both the groups. The durations of sensory and motor blocks were 502.66 ± 43.78 and 557.67 ± 38.83 min respectively, in Group H, whereas they were 535.9 ± 43.78 and 558.40 ± 38.83 min, respectively, in Group D. The duration of analgesia was 525.33 ± 42.99 min, significantly less in Group H compared to 610.20 ± 42.89 min in Group D (P < 0.001). The quality of anaesthesia was significantly better in dexmedetomidine group compared to hyaluronidase group (P < 0.001).

Conclusion:

The addition of dexmedetomidine prolongs the durations of sensory and motor block and duration of analgesia and improves the quality of anaesthesia as compared with hyaluronidasee when injected with bupivacaine in supraclavicular brachial plexus block.