A Comparative Study of Ropivacaine Alone Versus Ropivacaine With Dexmedetomidine in Supraclavicular Brachial Plexus Block.
Various approaches of brachial plexus block have been used for upper limb surgeries but supraclavicular
brachial plexus block is mainly used for any surgery in the upper
extremity that does not involve the shoulder because it is a safe
technique with rapid onset and reliable anesthesia.
Various local anesthetics have been used to provide brachial plexus block. Ropivacaine, a
long-acting amide local anaesthetic related structurally to bupivacaine, has
been used for supraclavicular block in upper limb surgery.
It provides pain relief with less motor blockade and is less cardiotoxic than
bupivacaine, which makes it a more suitable agent for supraclavicular brachial
plexus block. A variety of adjuvant has been already studied for brachial plexus blockade.
Dexmedetomidine, a highly selective α-2 agonist with a relatively high ratio of α-2:α-1
activity, possesses all these properties but lacks respiratory depression, making
it a useful and safe adjunct in diverse clinical applications. Presynaptic alpha-2
adrenoceptors are present in sympathetic nerve endings and
noradrenergic neurones in the central nervous system where
dexmedetomidine binds and inhibits the release of noradrenaline.
Dexmedetomidine has shown greater affinity as an α-2 adrenoreceptor agonist than clonidine. The effect of dexmedetomidine when added to lidocaine for intravenous regional anaesthesia, demonstrated that addition of 1 mcg/kg
dexmedetomidine to lidocaine improves quality of anaesthesia and intraoperative
as well post-operative analgesia without causing side effects.
Res Pract Anesthesiol Open J. 2016; 1(1): 28-34. doi: 10.17140/RPAOJ-1-107
