EXAMINING THE VARIATIONS IN INTRAVENOUS AND PERINEURAL DEXMEDETOMIDINE SEDATED BRACHIAL PLEXUS BLOCK DURING A SPECIFIC APPROACH IN UPPER LIMB ORTHOPAEDIC SURGERY

Abstract

Background: The adjuvant analgesic dexmedetomidine is widely used in intravenous and intrathecal infusions. The 
function of perineural dexmedetomidine has also been discussed recently. Still, there is a dearth of information in the 
literature about the problem. 
Aim: In this study, the effectiveness of intravenous vs perineural dexmedetomidine sedation on supraclavicular 
approach brachial plexus block during upper limb orthopaedic surgery was evaluated.  
Methods: 80 subjects were split into two groups of 40 subjects each at random. Group I received a loading dose of 1 
mcg/kg/IV dexmedetomidine for 10 minutes, after which they received a continuous IV infusion of 0.4 mcg/kg/hr of 
dexmedetomidine and Group II received 1 mcg/kg perineural dexmedetomidine. Along with any adverse effects 
experienced, the length and beginning of the motor and sensory block, the requirement for postoperative analgesics, 
haemodynamic parameters, and Ramsay sedation levels were evaluated in both groups. 
Results: Group I had a substantially larger mean sensory block onset (p<0.05), whereas the mean motor block onset 
in the two groups was similar (p>0.05). Group I experienced a considerably longer period of motor and sensory 
blockage (p<0.05). Throughout the course of the study, Group I patients had reduced pulse rates, systolic and diastolic 
blood pressure, and equivalent SpO2 values. The Ramsay sedation score did not change. At 9, 12, and 15 hours 
postoperatively, Group I had noticeably lower scores (p<0.05). Group I had a substantially greater mean analgesia 
rescue time with VAS >4 (p<0.05). 
Conclusions: The current study comes to the conclusion that, when compared to perineural dexmedetomidine, which 
is used as an adjuvant to supraclavicular block using 2% of 5 mg/kg lidocaine and 0.5% of 2 mg/kg bupivacaine for 
upper limb orthopaedic surgeries, early sensory block onset was seen with significantly longer duration of analgesia, 
motor, and sensory block.