A Study to Compare the Analgesic Efficacy of Dexmedetomidine and Fentanyl As Adjuvants to Levobupivacaine in Ultrasound-Guided Supraclavicular Brachial Plexus Block

Background: Supraclavicular brachial plexus provides complete and reliable anesthesia for upper limb surgeries. Adjuvants are added to local anesthetists to improve various block characteristics. There are limited studies comparing the efficacy of dexmedetomidine and fentanyl as an adjuvant to levobupivacaine.

Aims: The aim of the study was to evaluate and compare the effect of dexmedetomidine versus fentanyl as an adjuvant with levobupivacaine in ultrasound-guided supraclavicular brachial plexus block.

Settings And Design: This study design was a prospective, randomized, double-blind controlled study.

Subjects And Methods: A total of 120 patients in the age group of 30-55 years with physical status American Society of Anesthesiologists Classes I and II undergoing elective upper limb surgeries under ultrasound-guided supraclavicular brachial plexus block were randomly divided into three groups of forty each after taking informed consent and approval from Hospital Ethics Committee: Group A received 25 ml of 0.5% levobupivacaine with 5 ml normal saline (NS). Group B received 25 ml of 0.5% levobupivacaine with 1 μg/kg dexmedetomidine diluted to the volume of 5 ml NS. Group C received 25 ml of 0.5% levobupivacaine with 1 μg/kg fentanyl diluted to the volume of 5 ml NS. Onset and duration of sensory and motor block and duration of analgesia were noted and any side effects were observed.

Statistical Analysis: The distribution of variables tested with Shapiro-Wilk test. Group comparison of values was made by Kruskal-Wallis test followed by Mann-Whitney test.

Results: There was fastest onset time as well as longer duration of sensory and motor block in dexmedetomidine group, intermediate in fentanyl group as compared to levobupivacaine group.

Conclusion: This study concludes that addition of dexmedetomidine to levobupivacaine for supraclavicular brachial plexus block shortens the onset time and prolongs the duration of sensory and motor blockade as compared to the addition of fentanyl.