Comparison of effects of ropivacaine with and without dexmedetomidine in axillary brachial plexus block: A prospective randomized double-blinded clinical trial

Background: Addition of dexmedetomidine to ropivacaine for peripheral nerve blocks has shown to improve the efficacy of ropivacaine by prolonging the duration of analgesia. This study was undertaken to evaluate the effects of ropivacaine alone and in combination with dexmedetomidine in the axillary block. Materials and Methods: A total of 80 patients belonging to American Society of Anesthesiologists physical status I, II, and III, scheduled for elective forearm and/or hand surgeries were randomly allocated into one of the two groups to receive either 39 ml of 0.375% ropivacaine and 1 ml normal saline (Group R) or 39 ml of 0.375% ropivacaine and 1 mg/kg dexmedetomidine diluted to 1 ml with normal saline (Group RD). Results: There was a significant early the onset of sensory and the motor block in Group RD. Duration of sensory block in Group RD was 677.25 99.64 min and in Group R was 494.38 70.64 min and the difference was clinically significant (P < 0.001). Duration of motor block in Group RD was 712.88 89.32 min and in Group R was 526.25 70.229 min and was clinically significant. Duration of analgesia in Group RD was 764.38 110.275 min and that in Group R was 576.88 76.306 min and was clinically significant. There was a significant alteration in hemodynamics in Group RD when compared to Group R without any side effects. Conclusion: Dexmedetomidine as an adjuvant to ropivacaine provides quicker onset of anesthesia, longer duration of analgesia. It offers convenient, simple, effective mode of anesthesia, and postoperative analgesia for forearm and/or hand surgeries.