Comparison of Efficacy of 0.75% Ropivacaine Along With Combination Of 0.75% Ropivacaine and Dexmeditomidine in Ultrasound Guided Axillary Brachial Plexus Block in Forearm and Hand Surgeries

Abstract

Background: Axillary brachial plexus block is a widely utilized technique for upper limb surgeries, and the search for effective adjuvants to local anesthetics continues. Dexmedetomidine, an alpha-2 adrenergic agonist, has shown potential to enhance the quality of nerve blocks. This study aimed to compare the efficacy of Ropivacaine 0.75% with and without Dexmedetomidine in axillary brachial plexus blocks.

Methods: This prospective, randomized, comparative study enrolled patients undergoing upper limb surgery, who were allocated into two groups: Group A received Ropivacaine 0.75% with Dexmedetomidine, and Group B received Ropivacaine 0.75% alone. Demographic data, onset and duration of sensory and motor block, duration of analgesia, hemodynamic parameters, and complication rates were recorded and analyzed for statistical significance.

Results: Both groups were demographically comparable in terms of age, sex distribution, body weight, and ASA physical status, with no significant differences observed. Group A exhibited a significantly faster onset of sensory and motor block compared to Group B, and also demonstrated prolonged durations of both sensory and motor blockade. The duration of analgesia was notably extended in Group A. Hemodynamic variables, including systolic and diastolic blood pressure, mean arterial pressure, oxygen saturation, and heart rate, remained largely stable and comparable across groups, with only a transient statistically significant difference in heart rate at 10 minutes. Although minor complications were slightly more frequent in Group A, this difference was not statistically significant, and all adverse events were self limiting.

Conclusions: The addition of Dexmedetomidine to Ropivacaine 0.75% in axillary brachial plexus block significantly improves the onset and duration of sensory and 13motor blockade and enhances postoperative analgesia, without compromising hemodynamic stability. The minor increase in complication rate was not statistically significant and did not impact overall safety.