Upper Limb Surgeriesunder Brachial Plexus Block Using Infusion of Dexmedetomidine or Propofolfor Monitored Anaesthesia Care - A Comparative Study

Upper Limb Surgeries under Brachial Plexus Block

  • Kumkum Gupta Professor, Department of Anaesthesiology and Critical care,Subharti Medical College, Swami VivekanandSubharti University, NH-58 Bye Pass Road, Meerut-UP, India
  • Salony Agarwal Associate Professor, Department of Anaesthesiology and Critical care,Subharti Medical College, Swami Vivekanand Subharti University, NH-58 Bye Pass Road, Meerut-UP, India
  • Prashant K Gupta Director & Professor, Department of Radio diagnosis and Imaging,Subharti Medical College, Swami VivekanandSubharti University, NH-58 Bye Pass Road, Meerut-UP, India
  • Abhishake Kumar Professor. Department of Anaesthesiology and Critical care,Subharti Medical College, Swami VivekanandSubharti University, NH-58 Bye Pass Road, Meerut-UP, India
  • Pavitra Kalra Resident, Department of Anaesthesiology and Critical care,Subharti Medical College, Swami VivekanandSubharti University, NH-58 Bye Pass Road, Meerut-UP, India
  • Kopal Gupta Resident, Department of Anaesthesiology and Critical careSubharti Medical College, Swami VivekanandSubharti University, NH-58 Bye Pass Road, Meerut-UP, India
Keywords: Brachial plexus block, Dexmedetomidine, Monitored anaesthesia care, Propofol, Ultrasound guidance

Abstract

Background: Brachial plexus block is widely used for upper limb surgeries but intraoperatively,patients remain awake and anxious. This study has compared the intraoperative sedation of dexmedetomidine infusion versus propofol infusion during upper limb surgeriesby using monitored anesthesia care.Subjects and Methods:Sixty adult consenting patients of ASA physical status I to III of either    genderwereenrolled and brachial plexus block was established with 20 mL of 0.5% bupivacaine using ultrasound. Patients were randomized into two equal groups of 30 patients each to receive either dexmedetomidine1µg/kgover 10 min, followed by maintenance fusion of 0.4 µg/kg/h (Group D) or propofol infusion of 75µg/kg/min over 10 min,followed by 50µg/kg/min (Group P). Intraoperative sedation and duration of postoperative analgesia were primary objectives. The hemodynamic changes, respiratory depression, recovery from sedationor any adverse events were noted as secondary outcomes.Results:Ultrasound helped to observe the spread of local anesthetic agent at brachial plexus. The patients of propofol group had faster onset with early recovery from sedationbut sedation in patients of dexmedetomidine was clinically better with statistically significant difference. Duration of postoperative analgesia was also significantly enhanced with dexmedetomidine infusion. In propofol group, the blood pressure and heart rate remained lower when compared to dexmedetomidine infusion. There was no episode of respiratory depression in any patient.Conclusion: Dexmedetomidine infusion was better due to its stable hemodynamic profile, better intraoperative sedation and enhanced duration of postoperative analgesia without respiratory depressionduring upper limb surgeries.

Published
2019-10-01
How to Cite
Kumkum Gupta, Salony Agarwal, Prashant K Gupta, Abhishake Kumar, Pavitra Kalra, & Kopal Gupta. (2019). Upper Limb Surgeriesunder Brachial Plexus Block Using Infusion of Dexmedetomidine or Propofolfor Monitored Anaesthesia Care - A Comparative Study . Academia Anesthesiologica International, 4(2), 159-163. Retrieved from http://aijournals.com/index.php/aan/article/view/969