Efficacy of Ropivacaine alone Versus Ropivacaine with Dexmedetomidine in Ultrasound-guided Supraclavicular Brachial Plexus Block: A Randomised Controlled Study

Introduction: The Supraclavicular Brachial (SCB) plexus block for upper limb surgeries has emerged as a rapid and reliable technique compared to general anaesthesia. With the advent of Ultrasound (US), the SCB plexus block has become an easy, accurate and popular procedure to perform. Dexmedetomidine, as an adjuvant to local anaesthetics, has improved the quality of the blocks. Aim: To compare the onset and duration of sensory and motor blockade of 0.5% ropivacaine versus 0.5% ropivacaine with 25 mu g dexmedetomidine, as well as to assess the haemodynamic parameters in the SCB plexus block. Materials and Methods: This randomised controlled study was conducted at Osmania Medical College and General Hospital, Hyderabad, Telangana, India which included 60 adult patients {American Society of Anaesthesiologists (ASA) Iand II} scheduled for elective upper limb surgery under SCB, according to the inclusion criteria. The patients were randomised into group R (n=30), which received 30 mL of ropivacaine with 1 mL of saline and group RD (n=30), which received 30 mL of ropivacaine with 25 mu g of dexmedetomidine. The onset and duration of sensory and motor block, the duration of analgesia, haemodynamic parameters and any complications were recorded, tabulated in an Excel sheet and analysed using an unpaired t-test. Results: The demographic data among both groups were comparable, with a male predominance. The onset of sensory and motor block was faster in group RD compared to group R, respectively (4.78 +/- 1.68 mins vs. 7.87 +/- 1.98 mins, p-value <0.001) and (8.4 +/- 2.34 mins vs. 12.3 +/- 2.95 mins, p-value <0.001). The duration of sensory and motor block was longer in group RD compared to group R, respectively (807.5 +/- 165.51 mins vs. 485 +/- 81.31 mins, p-value <0.001) and (685 +/- 62.74 mins vs. 465 +/- 72.62 mins, p-value <0.001). Haemodynamic stability was well maintained without any complications in group RD. Conclusion: The addition of dexmedetomidine as an adjuvant to ropivacaine in ultrasound-guided SCB accelerates the onset of sensory and motor block, prolongs the duration of the block and analgesia, thereby improving the quality of the SCB.