Efficacy of Perineural versus Systemic Dexmedetomidine as an Adjuvant to Bupivacaine for Surgical Anesthesia in Axillary Block

Authors

  • Kaukab Majeed Department of Anesthesia, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Amran Hafiz Department of Anesthesia, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Usman Eijaz Malik Department of Anesthesia, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Fayyaz Hussain Department of Anesthesia, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Najm Us Saqib Department of Anesthesia, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Amna Gulraz Department of Anesthesia, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v73i4.8506

Keywords:

Axillary block, Bupivacaine, Dexmedetomidine

Abstract

Objective: To compare the analgesic effect of different routes of Dexmedetomidine when given as an adjuvant to Bupivacaine in the axillary block for surgical correction of radius fracture.

Study Design: Quasi-experimental study.

Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi Pakistan, from Sep 2021 to Feb 2022.

Methodology: The patients were divided into two equal groups. Group-A (Perineural Dexmedetomidine) and Group B (Intravenous Dexmedetomidine). Group-A received 1ug/kg Perineural Dexmedetomidine along with 30ml of racemic Bupivacaine (0.5%), and Group-B participants received 1ug per kg intravenous Dexmedetomidine after axillary block with 30ml of 0.5% perineural racemic Bupivacaine. The mean duration of analgesia was the primary outcome, and adverse outcomes and sedation were the secondary outcomes.

Results: The duration of analgesia was greater in the perineural Dexmedetomidine Group, with a mean duration of 610.20±29.92 minutes in comparison to the systemic Dexmedetomidine Group, which was 449±39.010 minutes, with pvalue<0.001. Numerical rating scores were higher, and sedation scores were lower in the perineural Dexmedetomidine Group,
making it a safer choice.

Conclusion: Perineural Dexmedetomidine is superior to intravenous Dexmedetomidine when used as an adjuvant to Bupivacaine in axillary brachial plexus block. It prolongs analgesia and is a safer alternative to intravenous Dexmedetomidine as an adjuvant.

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Published

31-08-2023

Issue

Section

Original Articles

How to Cite

1.
Majeed K, Hafiz A, Hussain F, Saqib NU, Gulraz A. Efficacy of Perineural versus Systemic Dexmedetomidine as an Adjuvant to Bupivacaine for Surgical Anesthesia in Axillary Block. Pak Armed Forces Med J [Internet]. 2023 Aug. 31 [cited 2024 Oct. 4];73(4):1145-8. Available from: https://www.pafmj.org/PAFMJ/article/view/8506