Effect of addition of buprenorphine versus dexmedetomidine to lignocaine with adrenaline in supraclavicular brachial plexus block- a comparative study

Background and objectives: Brachial plexus block (BPB) for upper extremity surgery provides superior analgesia, but this advantage is limited by the pharmacological duration of local anesthetics. Buprenorphine and Dexmedetomidine are used as adjuvants with local anesthetics in supraclavicular brachial plexus block to prolong and improve the quality of intraoperative anesthesia and post operative analgesia. Our study aimed to compare the effect of the addition of Buprenorphine versus Dexmedetomidine to Lignocaine with Adrenaline in supraclavicular brachial plexus block for forearm surgeries.
Methods: A total of 60 adult patients of ASA grade 1 or 2 scheduled for forearm surgeries under supraclavicular brachial plexus block were included in the study. Patients were randomly allocated into one of the two groups. Each group consisted of 30 patients. Group A patients received 7mg/kg of 1.5% Lignocaine with Adrenaline +3μg/kg of Buprenorphine. Group B patients received 7mg/kg of 1.5% Lignocaine with Adrenaline+1μg/kg of Dexmedetomidine. Onset and duration of sensory and motor blockade and duration of post operative analgesia were assessed.
Results: Mean time of onset of sensory block was 11.00 ± 1.64 min in patients of group A and 13.76 ± 1.77 min in patients of group B which was statistically significant with a p value <0.0001. Mean time of onset of motor block was 13.36 ± 1.95 min in group A and 16.06 ± 1.99 min in group B which was statistically significant with a p value<0.0001. Mean duration of sensory block was 442.00 ± 33.05 min in group A and 299.00 ± 17.68 min in group B which was also statistically significant with a p value<0.0001. Mean duration of motor block was 381.33 ± 34.91 min in group A and 241.66 ± 18.01 min in group B which was statistically significant with a p value<0.0001. Mean duration of post operative analgesia was 452.33 ± 32.45 min in group A and 309.33 ± 18.18 min in group B which was also statistically significant with a p value<0.0001. No side effects were noted in both groups.
Conclusion: From our study we concluded that Buprenorphine when compared to Dexmedetomidine shortens the onset time of sensory and motor blockade and increases the duration of sensory and motor block, as well as duration of post operative analgesia when used as an adjuvant with Lignocaine with Adrenaline in supraclavicular brachial plexus block.