Comparison of dexmedetomidine and epinephrine as an adjuvant to 1% mepivacaine in brachial plexus block.
10.4097/kjae.2014.66.4.283
- Author:
Jang Ho SONG
1
;
Hee Yong SHIM
;
Tong Joo LEE
;
Jong Kwon JUNG
;
Young Deog CHA
;
Doo Ik LEE
;
Gun Woo KIM
;
Jeong Uk HAN
Author Information
1. Department of Anesthesiology and Pain Medicine, Inha University School of Medicine, Incheon, Korea. jwhanan@nate.com
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
Brachial plexus;
Dexmedetomidine;
Epinephrine
- MeSH:
Anesthesia, Local;
Anesthetics, Local;
Blood Pressure;
Brachial Plexus*;
Dexmedetomidine*;
Epinephrine*;
Heart Rate;
Humans;
Mepivacaine*;
Nerve Block;
Oxygen;
Upper Extremity
- From:Korean Journal of Anesthesiology
2014;66(4):283-289
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Dexmedetomidine extends the duration of nerve block when administered perineurally together with local anesthetics by central and/or peripheral action. In this study, we compared the duration of nerve block between dexmedetomidine and epinephrine as an adjuvant to 1% mepivacaine in infraclavicular brachial plexus block. METHODS: Thirty patients, scheduled for upper limb surgery were assigned randomly to 3 groups of 10 patients each. We performed brachial plexus block using a nerve stimulator. In the control group (group C), patients received 40 ml of 1% mepivacaine. In group E, patients received 40 ml of 1% mepivacaine containing 200 microg of epinephrine as an adjuvant. In group D, patients received 40 ml of 1% mepivacaine containing 1 microg/kg of dexmedetomidine as an adjuvant. Sensory block duration, motor block duration, time to sense pain, and onset time were assessed. We also monitored blood pressure, heart rate, oxygen saturation and bispectral index. RESULTS: In group D and group E, sensory block duration, motor block duration and time to sense first pain were prolonged significantly compared to group C. However, there was no significant difference between group D and group E. CONCLUSIONS: Perineural 1 microg/kg of dexmedetomidine similarly prolonged nerve block duration compared to 200 microg of epinephrine, but slowed heart rate. Thus, dexmedetomidine is expected to be a good alternative as an adjuvant to local anesthesia in patients who are cautioned against epinephrine.
