Efficacy of Magnesium Sulfate and Dexmedetomidine as Adjuvants to Ropivacaine in Supraclavicular Brachial Plexus Block: A Randomised Clinical Study
Introduction: Peripheral nerve blocks have recently proven to be extremely promising in terms of patient satisfaction. In upper limb procedures, rapid and deep anaesthesia can be achieved with supraclavicular ultrasound-guided access to the brachial plexus. To improve the quality of local anaesthesi...
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JCDR Research and Publications Private Limited
2024-03-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://www.jcdr.net/articles/PDF/19112/69087_CE[Ra1]_F(IS)_QC(AnK_RDW_IS)_PF1(VD_DK_OM)_PFA(NC)_PN(KM).pdf |
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| author | Poonam Singh Nidhi Gupta Rajesh Kumar Apoorva Jaiswal Sahil Jaggi Raydhi Sharma |
| author_facet | Poonam Singh Nidhi Gupta Rajesh Kumar Apoorva Jaiswal Sahil Jaggi Raydhi Sharma |
| author_sort | Poonam Singh |
| collection | DOAJ |
| description | Introduction: Peripheral nerve blocks have recently proven to be extremely promising in terms of patient satisfaction. In upper limb procedures, rapid and deep anaesthesia can be achieved with supraclavicular ultrasound-guided access to the brachial plexus. To improve the quality of local anaesthesia, adjuvants such as magnesium sulfate and dexmedetomidine have been added to the local anaesthetic.
Aim: To evaluate the efficacy of magnesium sulfate and dexmedetomidine as adjuvants to ropivacaine in supraclavicular Brachial Plexus Blockade (BPB).
Materials and Methods: A prospective randomised double-blind study was conducted in the Department of Anaesthesiology from June 2016 to November 2017 ( 1 year and 6 months) at King George's Medical University, Lucknow, Uttar Pradesh, India. A total of 60 patients were divided into two groups using a computer-generated random number for upper limb surgeries (below the mid-humerus) under supraclavicular brachial plexus block. Group A (n=30) received ropivacaine 0.5% (30 mL) plus dexmedetomidine 50 μg for the supraclavicular block, and Group B received ropivacaine 0.5% (30 mL) plus magnesium sulfate 150 mg in 1 mL Normal Saline (NS) 0.9% for the same block. A comparison of these two groups was conducted for the time of onset, duration of sensory and motor block, haemodynamic stability, postoperative analgesia, and complications. Statistical analyses such as Student’s t-test, Chi-square test, and Mann-Whitney U-test were used.
Results: The mean age of Group A was 28.03±5.86 years and Group B was 31.07±7.06 years. The sensory block and motor block onset were significantly faster among patients of Group A (6.47±1.43 min and 8.50±1.46 min) compared to Group B (9.57±1.22 min and 11.77±1.19 min). The mean duration of analgesia was significantly longer (p<0.001) in Group A (1034.10±61.07 min) compared to Group B (460.00±35.82 min). The duration of sensory block and motor block was also significantly higher (p<0.001) in Group A compared to Group B. Both groups were haemodynamically stable, but sedation was significantly higher in Group A.
Conclusion: Dexmedetomidine 50 μg is a superior adjuvant compared to magnesium sulfate 150 mg with ropivacaine 0.5% in supraclavicular brachial plexus block as it significantly hastens onset time and prolongs the duration of sensory and motor blocks and the duration of analgesia. |
| first_indexed | 2024-03-07T19:59:24Z |
| format | Article |
| id | doaj.art-c462dc9ffba649229f02f26e8c472015 |
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| publishDate | 2024-03-01 |
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| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-c462dc9ffba649229f02f26e8c4720152024-02-28T11:21:23ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2024-03-011803010510.7860/JCDR/2024/69087.19112Efficacy of Magnesium Sulfate and Dexmedetomidine as Adjuvants to Ropivacaine in Supraclavicular Brachial Plexus Block: A Randomised Clinical StudyPoonam Singh0Nidhi Gupta1Rajesh Kumar2Apoorva Jaiswal3Sahil Jaggi4Raydhi Sharma5Assistant Professor, Department of Anaesthesiology, School of Medical Science and Research, Sharda University, Greater Noida, Uttar Pradesh, India.Assistant Professor, Department of Anaesthesiology, Government Doon Medical College, Dehradun , Uttarakhand, India.Assistant Professor, Department of Anaesthesiology, Era Medical College, Lucknow, Uttar Pradesh, India.Junior Resident, Department of Anaesthesiology, King George's Medical University, Lucknow, Uttar Pradesh, India.Junior Resident, Department of Anaesthesiology, Era Medical College, Lucknow, Uttar Pradesh, India.Junior Resident, Department of Anaesthesiology, Era Medical College, Lucknow, Uttar Pradesh, India.Introduction: Peripheral nerve blocks have recently proven to be extremely promising in terms of patient satisfaction. In upper limb procedures, rapid and deep anaesthesia can be achieved with supraclavicular ultrasound-guided access to the brachial plexus. To improve the quality of local anaesthesia, adjuvants such as magnesium sulfate and dexmedetomidine have been added to the local anaesthetic. Aim: To evaluate the efficacy of magnesium sulfate and dexmedetomidine as adjuvants to ropivacaine in supraclavicular Brachial Plexus Blockade (BPB). Materials and Methods: A prospective randomised double-blind study was conducted in the Department of Anaesthesiology from June 2016 to November 2017 ( 1 year and 6 months) at King George's Medical University, Lucknow, Uttar Pradesh, India. A total of 60 patients were divided into two groups using a computer-generated random number for upper limb surgeries (below the mid-humerus) under supraclavicular brachial plexus block. Group A (n=30) received ropivacaine 0.5% (30 mL) plus dexmedetomidine 50 μg for the supraclavicular block, and Group B received ropivacaine 0.5% (30 mL) plus magnesium sulfate 150 mg in 1 mL Normal Saline (NS) 0.9% for the same block. A comparison of these two groups was conducted for the time of onset, duration of sensory and motor block, haemodynamic stability, postoperative analgesia, and complications. Statistical analyses such as Student’s t-test, Chi-square test, and Mann-Whitney U-test were used. Results: The mean age of Group A was 28.03±5.86 years and Group B was 31.07±7.06 years. The sensory block and motor block onset were significantly faster among patients of Group A (6.47±1.43 min and 8.50±1.46 min) compared to Group B (9.57±1.22 min and 11.77±1.19 min). The mean duration of analgesia was significantly longer (p<0.001) in Group A (1034.10±61.07 min) compared to Group B (460.00±35.82 min). The duration of sensory block and motor block was also significantly higher (p<0.001) in Group A compared to Group B. Both groups were haemodynamically stable, but sedation was significantly higher in Group A. Conclusion: Dexmedetomidine 50 μg is a superior adjuvant compared to magnesium sulfate 150 mg with ropivacaine 0.5% in supraclavicular brachial plexus block as it significantly hastens onset time and prolongs the duration of sensory and motor blocks and the duration of analgesia.https://www.jcdr.net/articles/PDF/19112/69087_CE[Ra1]_F(IS)_QC(AnK_RDW_IS)_PF1(VD_DK_OM)_PFA(NC)_PN(KM).pdfhaemodynamic stabilitylimb surgerieslocal anaesthesiapostoperative analgesia |
| spellingShingle | Poonam Singh Nidhi Gupta Rajesh Kumar Apoorva Jaiswal Sahil Jaggi Raydhi Sharma Efficacy of Magnesium Sulfate and Dexmedetomidine as Adjuvants to Ropivacaine in Supraclavicular Brachial Plexus Block: A Randomised Clinical Study Journal of Clinical and Diagnostic Research haemodynamic stability limb surgeries local anaesthesia postoperative analgesia |
| title | Efficacy of Magnesium Sulfate and Dexmedetomidine as Adjuvants to Ropivacaine in Supraclavicular Brachial Plexus Block: A Randomised Clinical Study |
| title_full | Efficacy of Magnesium Sulfate and Dexmedetomidine as Adjuvants to Ropivacaine in Supraclavicular Brachial Plexus Block: A Randomised Clinical Study |
| title_fullStr | Efficacy of Magnesium Sulfate and Dexmedetomidine as Adjuvants to Ropivacaine in Supraclavicular Brachial Plexus Block: A Randomised Clinical Study |
| title_full_unstemmed | Efficacy of Magnesium Sulfate and Dexmedetomidine as Adjuvants to Ropivacaine in Supraclavicular Brachial Plexus Block: A Randomised Clinical Study |
| title_short | Efficacy of Magnesium Sulfate and Dexmedetomidine as Adjuvants to Ropivacaine in Supraclavicular Brachial Plexus Block: A Randomised Clinical Study |
| title_sort | efficacy of magnesium sulfate and dexmedetomidine as adjuvants to ropivacaine in supraclavicular brachial plexus block a randomised clinical study |
| topic | haemodynamic stability limb surgeries local anaesthesia postoperative analgesia |
| url | https://www.jcdr.net/articles/PDF/19112/69087_CE[Ra1]_F(IS)_QC(AnK_RDW_IS)_PF1(VD_DK_OM)_PFA(NC)_PN(KM).pdf |
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