Effect of dexmedetomidine versus nalbuphine on the onset and duration of sensory and motor block: A randomized prospective single-blinded controlled study.

Panchanana Sethi; Mrutyunjay Sahoo; Rojalin Sahoo; Ananta Narayan Patra; Dukhia Charan Kisku

doi:10.51168/7zs99744

Authors

Panchanana Sethi Assistant Professor, Department of Anaesthesiology, Pandit Raghunath Murmu Medical College and Hospital, Baripada.
Mrutyunjay Sahoo Assistant Professor, Department of Community Medicine,,Saheed Rendo Majhi Medical College & Hospital
Rojalin Sahoo Assistant Professor, Department of Anaesthesiology and Critical Care, Dharanidhar Medical College and Hospital.
Ananta Narayan Patra Assistant Professor, Department of Anaesthesiology and Critical Care, Dharanidhar Medical College and Hospital.
Dukhia Charan Kisku Senior Resident, Department of Anaesthesiology and Critical Care, Dharanidhar Medical College and Hospital

DOI:

https://doi.org/10.51168/7zs99744

Keywords:

dexmedetomidine, nalbuphine, analgesia, brachial plexus block, motor blockade

Abstract

Background:

The present study was conducted to compare dexmedetomidine and nalbuphine as adjuvants to levobupivacaine in supraclavicular brachial plexus block with respect to onset and duration of sensory and motor block, duration of analgesia, and hemodynamic changes.
Methods:

A randomized, prospective, single-blinded controlled study was conducted among 110 patients aged 18–55 years belonging to ASA grade I and II undergoing upper limb surgeries under supraclavicular brachial plexus block. Patients were randomly allocated into two groups of 55 each. Group LD received levobupivacaine with dexmedetomidine, while Group LN received levobupivacaine with nalbuphine. Sensory block onset, motor block onset, duration of sensory and motor block, duration of analgesia, pulse rate, mean arterial pressure, and oxygen saturation were assessed.

Results:

The mean age of participants in Group LD and Group LN was 36.40±10.89 years and 39.18±12.05 years, respectively. Dexmedetomidine significantly reduced the onset time of sensory block (7.29±0.76 min vs 10.07±1.11 min; p<0.001) and motor block (13.09±0.84 min vs 16.27±0.98 min; p<0.001). Duration of sensory block (13.21±1.16 h vs 12.14±1.11 h; p<0.001), motor block (10.01±1.04 h vs 7.30±0.74 h; p<0.001), and analgesia (13.83±0.78 h vs 12.07±0.99 h; p<0.001) were significantly prolonged in Group LD. Pulse rate and mean arterial pressure were significantly lower in Group LD at 60 min, 2 h, and 6 h. Oxygen saturation remained stable and comparable between groups throughout the study.

Conclusion:

Both dexmedetomidine and nalbuphine serve as effective adjuncts to levobupivacaine for supraclavicular brachial plexus blockade. Dexmedetomidine provides enhanced efficacy through rapid onset and extended analgesia, whereas nalbuphine presents a cost-effective option with a commendable safety profile.

Recommendation:

Dexmedetomidine may be preferred as an adjuvant to levobupivacaine for supraclavicular brachial plexus block due to its faster onset and prolonged analgesic effect, while nalbuphine can be considered a cost-effective alternative.

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