Joanny, Benjamin (2016) Prospective randomised controlled study evaluating dexmedetomidine as an adjuvant added to a local anaesthetic mixture of bupivacaine, lignocaine with adrenaline in axillary plexus block as compared to axillary plexus block with local anaesthetic mixture alone. Masters thesis, ESIC Medical College & Postgraduate Institute of Medical Science and Research, Chennai.
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Abstract
BACKGROUND: Regional anaesthesia in the form of Brachial plexus block is an attractive option when compared to General anaesthesia, since it has the advantages of post-operative pain relief as well as decreased nausea and vomiting. This makes regional anaesthesia the preferred technique in day care surgery. Axillary plexus block is one of the most commonly performed regional nerve block for upper limb surgeries. The proximity of the nerves of brachial plexus to the axillary artery makes the identification of structures easy with both nerve stimulator and ultrasound guided block. AIM: To compare the analgesic efficacy of dexmedetomidine added to bupivacaine, lignocaine with adrenaline mixture versus bupivacaine, lignocaine with adrenaline mixture alone in axillary plexus block for upper limb surgeries. METHODS: This study is a prospective randomized controlled study. The study involved 60 patients. They were randomly divided into two groups, Group RD received axillary plexus block with 50 microgram of dexmedetomidine added to local anaesthetic mixture and Group RL received axillary plexus block with local anaesthetic mixture alone. Both the groups were followed up for the onset of sensory and motor blockade and the duration of analgesia using the Visual Analog Scale score. RESULTS: Both the study and control groups were comparable in terms of age, height, weight and BMI. The mean arterial pressure of the patients in the dexmedetomidine group was 80.27 ± 6.39 mmHg whereas the mean arterial pressure in the control group was 97.47 ± 8.16 mmHg at the 45th minute. The mean pulse rate of the patients in the dexmedetomidine group was around 70 bpm and around 85 bpm in the control group but none of the patients required atropine. The onset time of sensory block in the dexmedetomidine group was found to be 9.37 ± 1.7 minutes whereas in the control group it was found to be 15.83 ± 1.18 minutes. The onset time of motor block in the dexmedetomidine group was found to be 12.23 ± 1.85 minutes whereas in the control group it was found to be 18.77 ± 1.22 minutes. The mean duration of analgesia in the dexmedetomidine group was found to be 16.53 ± 1.41 hours whereas the mean duration of analgesia in the control group was found to be 9.70 ± 1.44 hours. CONCLUSION: Dexmedetomidine in the dose of 50 microgram when added as an adjuvant to local anaesthetic mixture in axillary plexus block had a faster onset of sensory, motor block and significantly prolonged the duration of analgesia. They caused a minimal decrease in the mean arterial pressure and heart rate which did not warrant treatment.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Dexmedetomidine ; axillary block ; Visual Analog Scale (VAS). |
| Subjects: | MEDICAL > Anaesthesiology |
| Depositing User: | Punitha K |
| Date Deposited: | 15 Jun 2018 17:00 |
| Last Modified: | 15 Jun 2018 17:00 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/8497 |
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