A COMPARATIVE STUDY OF 0.5% LIGNOCAINE VERSUS 0.5% LIGNOCAINE WITH DEXMEDETOMIDINE FOR BIERS BLOCK IN UPPER LIMB SURGERIES

Dr P G Raghavendra, Dr Manjushree

Abstract


INTRODUCTION: Dexmedetomidine,a stereoisomer of medetomidine is a highlyselective alpha 2 adrenergic agonist and has been shown to
decrease anaesthetic requirements by upto 90% and to induce analgesia in rats ,volunteers and patients. It has been used successfully in
combination with local anaesthetics for procedures like spinal, epidural and brachial blocks.The present study was designed to evaluate the
quality,onset and recovery of IVRA with 0.5mcg/kg Dexmedetomidine added to 3mg/kg of 0.5% lignocaine.
METHODS: After institutional approval and informed consent, 60 ASA 1 &2volunteers, were taken into the study. In Group A 30 patients were
randomly allocated to receive IVRA for upper limb with 3mg/kg for 0.5% lignocaine; in Group B 30 patients randomly received IVRA of upper
limb with 3mg/kg of 0.5% lignocaine with 0.5mcg/kg Dexmedetomidine. The onset and recovery of sensory block were tested in six sites of the
forearm and hand, determined by pin prick, touch and cold. The cuff was released after 45 minutes. The onset of complete motor block was also
assessed and any symptoms after cuff deflation were recorded. Usual haemodynamic monitoring was used. Both groups were compared
statistically and results wereanalysed using SPSS version 18. Independent T test and chi-square test were used to find significant difference of study
parameters; p value of <0.05 was considered significant.
RESULTS: The speed of onset of sensory and motor block was higher in Group Bthan in Group A(p<0.05). The recovery of sensory and motor
block was prolonged in Group B than in Group A(p<0.05). The tourniquet pain occurred significantly later in Group B as compared to Group A.
There were few incidence of bradycardia in Group B.
CONCLUSION: Addition of 0.5mcg/kg of Dexmedetomidineas an adjuvant to IVRA effectively enhance the anaesthesia and post-operative
analgesia obtained with lignocaine. The low dose of Dexmedetomidine was effective and did not cause any major side-effects .


Keywords


IVRA: Intravenous Regional Anaesthesia, Local Anesthetic: Lignocaine Hydrochloride, α-2 agonist: Dexmedetomidine.

Full Text:

PDF

Refbacks

  • There are currently no refbacks.