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Efficacy of dexmedetomidine used as an adjuvant to 0.5% ropivacaine in ultrasound-guided supraclavicular brachial plexus block for upper limb surgeries

Background: Supraclavicular brachial plexus block (SCBPB) has gained popularity with the addition of various adjuncts to local anesthetics. This study aimed to evaluate the efficacy of dexmedetomidine as an adjuvant to 0.5% ropivacaine in ultrasound-guided (USG) SCBPB. Materials and Methods: One hundred patients of either sex, belonging to the American Society of Anesthesiologists physical status I or II, aged between 15 and 65 years and scheduled for elective upper arm surgery under USG SCBPB were enrolled. Patients were randomly allocated into two groups (n = 50). Both groups received 16 ml (120 mg) 0.75% ropivacaine with 1 μg/kg dexmedetomidine diluted in 8 ml normal saline (NS) (Group Ropivacaine Dexmedetomidine [RD]) or with 8 ml NS only (Group R). The primary outcome measure was the duration of analgesia, whereas secondary outcome measures were onset and duration of sensory and motor block, quality of anesthesia, sedation score, hemodynamic changes, and side effects. Statistical analysis was performed using unpaired Student's t-test or nonparametric Mann–Whitney test and Chi-square test. Results: The duration of analgesia was significantly prolonged in Group RD (730.70 ± 51.62 min) compared to Group R (388.30 ± 41.66 min), (P < 0.0001). The onset time of sensory and motor block was significantly shorter in Group RD in comparison to Group R (P < 0.001). The duration of sensory and motor block was significantly prolonged in Group RD compared to Group R, (P < 0.0001). The quality of anesthesia was significantly better in Group RD (P < 0.05). Sedation scores were significantly higher in Group RD (P < 0.05). No significant hemodynamic changes and side effects were observed in both groups (P > 0.05). Conclusion: Dexmedetomidine provides the prolonged duration of analgesia along with faster onset as well as prolonged duration of both sensory and motor block without any significant hemodynamic changes and side effects.