Singh Arvinder Pal, Mahindra Malika, Gupta Ruchi, Bajwa Sukhminder Jit Singh
Department of Anaesthesiology and Intensive Care, SGRD Medical College, Amritsar, Punjab, India.
Department of Anaesthesiology and Intensive Care, Adesh Hospital, Patiala, Punjab, India.
Anesth Essays Res. 2016 Sep-Dec;10(3):414-419. doi: 10.4103/0259-1162.176404.
Supplementation of dexmedetomidine produces a dose-dependent sedation, anxiolysis and analgesia without respiratory depression. This study was conducted to evaluate the possible effect of dexmedetomidine as an adjuvant to levobupivacaine for supraclavicular brachial plexus block in upper limb surgery.
Tertiary care institute, Department of Anaesthesiology and Intensive Care, a placebo-controlled study.
After obtaining Ethical Committee approval, a randomized, double-blind, placebo-controlled study was conducted on sixty American Society of Anesthesiologists physical status I and II patients in the age group of 18-60 years, divided randomly into two groups, Group I received 30 ml of 0.5% levobupivacaine with 1 ml of isotonic sodium chloride solution and Group II received 30 ml of 0.5% levobupivacaine and 1 ml (100 mcg) of dexmedetomidine for supraclavicular brachial plexus block. The onset and duration of sensory and motor blockade, duration of analgesia (DOA) and any adverse effects were noted. At the end of the study, data were compiled and analyzed using appropriate statistical tests. The value of < 0.05 was considered significant.
Demographic profile was comparable in both the groups. The time to onset of sensory and motor block was 10.54 ± 2.333 min and 12.21 ± 2.529 min in Group I while it was 3.24 ± 0.951 min and 2.83 ± 1.197 min in Group II, respectively. The duration of sensory and motor block was 7.79 ± 2.007 h and 9.18 ± 1.701 h in Group I, and it was 16.31 ± 2.606 h and 17.52 ± 2.098 h in Group II, respectively. The DOA was 678.68 ± 20.492 min in Group I and 1273.79 ± 83.139 min in Group II. On statistical comparison, these values were highly significant ( < 0.001). Side effects such as nausea, vomiting, hypoxemia, pruritis, or urinary retention were not observed in either of the groups.
Dexmedetomidine shortens the onset time for sensory and motor block significantly and prolongs DOA as well when used with levobupivacaine for supraclavicular brachial plexus block, without increasing the incidence of any adverse effects.
右美托咪定的补充可产生剂量依赖性的镇静、抗焦虑和镇痛作用，且无呼吸抑制。本研究旨在评估右美托咪定作为左布比卡因辅助药物用于上肢手术锁骨上臂丛神经阻滞的可能效果。
三级医疗机构，麻醉与重症监护科，一项安慰剂对照研究。
获得伦理委员会批准后，对60例年龄在18 - 60岁的美国麻醉医师协会身体状况I级和II级患者进行了一项随机、双盲、安慰剂对照研究，随机分为两组，I组接受30 ml 0.5%左布比卡因加1 ml等渗氯化钠溶液，II组接受30 ml 0.5%左布比卡因和1 ml（100 mcg）右美托咪定用于锁骨上臂丛神经阻滞。记录感觉和运动阻滞的起效时间和持续时间、镇痛持续时间（DOA）以及任何不良反应。研究结束时，使用适当的统计检验对数据进行整理和分析。P < 0.05的值被认为具有统计学意义。
两组的人口统计学特征具有可比性。I组感觉和运动阻滞的起效时间分别为10.54 ± 2.333分钟和12.21 ± 2.529分钟，而II组分别为3.24 ± 0.951分钟和2.83 ± 1.197分钟。I组感觉和运动阻滞的持续时间分别为7.79 ± 2.007小时和9.18 ± 1.701小时，II组分别为16.31 ± 2.606小时和17.52 ± 2.098小时。I组的DOA为678.68 ± 20.492分钟，II组为1273.79 ± 83.139分钟。经统计学比较，这些值具有高度统计学意义（P < 0.001）。两组均未观察到恶心、呕吐、低氧血症、瘙痒或尿潴留等副作用。
右美托咪定与左布比卡因联合用于锁骨上臂丛神经阻滞时，可显著缩短感觉和运动阻滞的起效时间，并延长DOA，且不增加任何不良反应的发生率。
