Low Interscalene Brachial Plexus Block with Dexmedetomidine and Clonidine as Adjuvants to Local Anaesthetic Mixture: A Double-blind Randomised Clinical Study
Introduction: For routine and emergency upper limb surgeries, brachial plexus block is better alternative to general anaesthesia. As compared to classic Interscalene brachial plexus Block (ISB), Low Interscalene Block (LISB) deposit Local Anaesthetic (LA) more caudad causing sensory-motor blockade o...
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Private Limited
2022-12-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://www.jcdr.net/articles/PDF/17249/57123_260822_CE(AD)_F(KR)_PF1(SG_SHU)_redo_PFA(SHU)_PB(SG_SS)_PN(SS).pdf |
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| author | Balwinder Kaur Rekhi Tripat Kaur Bindra Lovepreet Kaur Priyanka Mehta Simrit Kaur |
| author_facet | Balwinder Kaur Rekhi Tripat Kaur Bindra Lovepreet Kaur Priyanka Mehta Simrit Kaur |
| author_sort | Balwinder Kaur Rekhi |
| collection | DOAJ |
| description | Introduction: For routine and emergency upper limb surgeries, brachial plexus block is better alternative to general anaesthesia. As compared to classic Interscalene brachial plexus Block (ISB), Low Interscalene Block (LISB) deposit Local Anaesthetic (LA) more caudad causing sensory-motor blockade of upper limb. It acts as bridge between supraclavicular and classic ISB. Local anaesthetic mixture are used to shorten the onset of sensory-motor blockade. Alongside, various adjuvants are mixed with LA to further improve quality of block.
Aim: To compare the efficacy of dexmedetomidine and clonidine as adjuvants to LA mixture in LISB for upper limb surgeries to assess onset and duration of sensory-motor block and to observe any complication associated with block.
Materials and Methods: This double-blind, randomised prospective clinical study was conducted on 90 patients, aged 18-60 years, posted for upper limb surgeries with American Society of Anaesthesiologists (ASA) grade I, II at a tertiary care centre of Government Medical College, Patiala, Punjab, India from February 2021 to November 2021. The patients were randomly divided into three groups. Group I: levo-bupivacaine 0.5% (20 mL)+lignocaine 2% (10 mL)+Normal Saline (NS) (1 mL), group II: levo-bupivacaine 0.5% (20 mL)+lignocaine 2% (10 mL)+dexmedetomidine 50 mcg (1 mL), group III: levo-bupivacaine 0.5% (20 mL)+lignocaine 2% (10 mL)+clonidine 50 mcg (1 mL). The parameters observed were: onset and duration of sensory and motor block, any intraoperative complication. Data was compiled with the help of MS-Excel and analysis done with IBM Statistical Package for Social Sciences (SPSS) version 22.0.
Results: The mean onset time of sensory and motor block was faster in group II (4.20±0.62, 5.25±0.89 min) as compared to group III (5.24±0.99, 6.23±0.96 min) and group I (6.48±0.87, 7.03±1.02 min). The mean duration of sensory and motor block was prolonged in group II (743.38±12.55, 673.21±22.29 min) as compared to group III (480.65±14.72, 433.03±7.28 min) and group I (311.28±5.75, 272.03±6.09 min). No adverse effect was observed during this study.
Conclusion: Dexmedetomidine was more effective than clonidine as an adjuvant to LA mixture (0.5% levobupivaciane+2% lignocaine) in low interscalene brachial plexus block and no episode of pneumothorax and phrenic nerve palsy was seen. |
| first_indexed | 2024-04-10T20:54:56Z |
| format | Article |
| id | doaj.art-bd1e9f7a2f454fd4af109a21f50c83b6 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-04-10T20:54:56Z |
| publishDate | 2022-12-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-bd1e9f7a2f454fd4af109a21f50c83b62023-01-23T07:33:56ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2022-12-011612UC10UC1410.7860/JCDR/2022/57123.17249Low Interscalene Brachial Plexus Block with Dexmedetomidine and Clonidine as Adjuvants to Local Anaesthetic Mixture: A Double-blind Randomised Clinical StudyBalwinder Kaur Rekhi0Tripat Kaur Bindra1Lovepreet Kaur2Priyanka Mehta3Simrit Kaur4Professor, Department of Anaesthesiology and Intensive Care, Government Medical College, Patiala, Punjab, India.Professor, Department of Anaesthesiology and Intensive Care, Government Medical College, Patiala, Punjab, India.Junior Resident, Department of Anaesthesiology and Intensive Care, Government Medical College, Patiala, Punjab, India.Senior Resident, Department of Anaesthesiology and Intensive Care, Government Medical College, Patiala, Punjab, India.Associate Professor, Department of Anaesthesiology and Intensive Care, Government Medical College, Patiala, Punjab, India.Introduction: For routine and emergency upper limb surgeries, brachial plexus block is better alternative to general anaesthesia. As compared to classic Interscalene brachial plexus Block (ISB), Low Interscalene Block (LISB) deposit Local Anaesthetic (LA) more caudad causing sensory-motor blockade of upper limb. It acts as bridge between supraclavicular and classic ISB. Local anaesthetic mixture are used to shorten the onset of sensory-motor blockade. Alongside, various adjuvants are mixed with LA to further improve quality of block. Aim: To compare the efficacy of dexmedetomidine and clonidine as adjuvants to LA mixture in LISB for upper limb surgeries to assess onset and duration of sensory-motor block and to observe any complication associated with block. Materials and Methods: This double-blind, randomised prospective clinical study was conducted on 90 patients, aged 18-60 years, posted for upper limb surgeries with American Society of Anaesthesiologists (ASA) grade I, II at a tertiary care centre of Government Medical College, Patiala, Punjab, India from February 2021 to November 2021. The patients were randomly divided into three groups. Group I: levo-bupivacaine 0.5% (20 mL)+lignocaine 2% (10 mL)+Normal Saline (NS) (1 mL), group II: levo-bupivacaine 0.5% (20 mL)+lignocaine 2% (10 mL)+dexmedetomidine 50 mcg (1 mL), group III: levo-bupivacaine 0.5% (20 mL)+lignocaine 2% (10 mL)+clonidine 50 mcg (1 mL). The parameters observed were: onset and duration of sensory and motor block, any intraoperative complication. Data was compiled with the help of MS-Excel and analysis done with IBM Statistical Package for Social Sciences (SPSS) version 22.0. Results: The mean onset time of sensory and motor block was faster in group II (4.20±0.62, 5.25±0.89 min) as compared to group III (5.24±0.99, 6.23±0.96 min) and group I (6.48±0.87, 7.03±1.02 min). The mean duration of sensory and motor block was prolonged in group II (743.38±12.55, 673.21±22.29 min) as compared to group III (480.65±14.72, 433.03±7.28 min) and group I (311.28±5.75, 272.03±6.09 min). No adverse effect was observed during this study. Conclusion: Dexmedetomidine was more effective than clonidine as an adjuvant to LA mixture (0.5% levobupivaciane+2% lignocaine) in low interscalene brachial plexus block and no episode of pneumothorax and phrenic nerve palsy was seen.https://www.jcdr.net/articles/PDF/17249/57123_260822_CE(AD)_F(KR)_PF1(SG_SHU)_redo_PFA(SHU)_PB(SG_SS)_PN(SS).pdfmotor blockpneumothoraxsensory block |
| spellingShingle | Balwinder Kaur Rekhi Tripat Kaur Bindra Lovepreet Kaur Priyanka Mehta Simrit Kaur Low Interscalene Brachial Plexus Block with Dexmedetomidine and Clonidine as Adjuvants to Local Anaesthetic Mixture: A Double-blind Randomised Clinical Study Journal of Clinical and Diagnostic Research motor block pneumothorax sensory block |
| title | Low Interscalene Brachial Plexus Block with Dexmedetomidine and Clonidine as Adjuvants to Local Anaesthetic Mixture: A Double-blind Randomised Clinical Study |
| title_full | Low Interscalene Brachial Plexus Block with Dexmedetomidine and Clonidine as Adjuvants to Local Anaesthetic Mixture: A Double-blind Randomised Clinical Study |
| title_fullStr | Low Interscalene Brachial Plexus Block with Dexmedetomidine and Clonidine as Adjuvants to Local Anaesthetic Mixture: A Double-blind Randomised Clinical Study |
| title_full_unstemmed | Low Interscalene Brachial Plexus Block with Dexmedetomidine and Clonidine as Adjuvants to Local Anaesthetic Mixture: A Double-blind Randomised Clinical Study |
| title_short | Low Interscalene Brachial Plexus Block with Dexmedetomidine and Clonidine as Adjuvants to Local Anaesthetic Mixture: A Double-blind Randomised Clinical Study |
| title_sort | low interscalene brachial plexus block with dexmedetomidine and clonidine as adjuvants to local anaesthetic mixture a double blind randomised clinical study |
| topic | motor block pneumothorax sensory block |
| url | https://www.jcdr.net/articles/PDF/17249/57123_260822_CE(AD)_F(KR)_PF1(SG_SHU)_redo_PFA(SHU)_PB(SG_SS)_PN(SS).pdf |
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