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Introduction: Axillary block with Bupivacaine mixed with adjuvants like dexmedetomidine, a more selectivealpha2 adrenoreceptor agonist, induces faster onset of blockade, delays the absorption of local anaesthetic and prolongs its action. Steroid adjuvants like dexamethasone can decrease inflammation at the same time demonstrated prolonged analgesic effect. The study aimed at comparing the efficacy of these adjuvants in affecting regional block onset and duration. Materials and Methods: This Randomized, uncontrolled, single blinded, two-arm, concurrent parallel trial was conducted during January to March 2017 among 60 participants posted for forearm and hand surgeries randomly allocated into two groups viz: Group A: 30 subjects given a mixture (30ml) of Bupivacaine (0.25%) and Dexamethasone (8mg) and Group B: 30 subjects given 30ml a mixture (30ml) of Bupivacaine (0.25%) and 1 ml of dexmedotomidine (100μg). The intra and post-operative outcomes of the two groups were compared statistically. Results: The onset of motor and sensory blockade was significantly (p<0.001) earlier in the dexmedotomidine group (B) compared to the dexamethasone group (A). Similarly the duration of the sensory/motor blocks and duration of analgesia were significantly more (p<0.001) in group B compared to group A. Conclusion: Dexmedotomidine when compared with Dexamethasone used as an adjuvant to Bupivacaine in axillary block for forearm and hand surgeries showed marked efficacy in terms of earlier onset of action, prolonged blockade and longer duration of post-operative analgesia.

indian journal of clinical anaesthesia

Comparison of motor blockade, sensory blockade and duration of analgesia between dexmedotomidine and dexamethasone as an adjuvant to bupivacaine in axillary block