Abstract

Background: Supraclavicular approach of brachial plexus block has been popular technique in delivery of anesthesia in patients undergoing upper limb surgeries. Of various local anesthetics, bupivacaine is used most frequently for brachial plexus block. Any adjuvant to the local anesthetics for brachial plexus block prolongs its analgesic effect. Hence the present study was undertaken to compare the effect of dexmedetomidine and fentanyl as adjuvant to bupivacaine in supraclavicular nerve block for upper limb surgeries. Methods: A total 100 patients of ASA grade I and II were enrolled and randomly divided into two equal groups. Group A received 25-30mL of 0.5% Bupivacaine + 50μg Fentanyl and group B received 25-30mL of 0.5% Bupivacaine + 50μg Dexmedetomidine. The onset time and duration of sensory and motor blockade were recorded. Hemodynamic variables and duration of analgesia were recorded for 24 hours postoperatively. Results: The onset of sensory and motor block was significantly faster, and duration of sensory and motor block was significantly prolonged in group B as compared to group A (p<0.05). Rescue analgesic requirements were significantly less in group B compared to group A (p<0.05). Hemodynamic variables did not differ between groups in the post-operative period, except the pulse rate which was found to be on the higher side for fentanyl group. Conclusion: Addition of 50μg dexmedetomidine to 25-30ml bupivacaine 0.5% in supraclavicular brachial plexus block was more effective in prolongation of sensory and motor duration as well as providing adequate intra-operative analgesia when compared to 50μg fentanyl with 25-30ml bupivacaine 0.5%, without producing any adverse events.