EVALUATION OF THE EFFECT OF DEXMEDETOMIDINE AS ADJUVANT TO ROPIVACAINE IN ULTRASOUND GUIDED POPLITEAL SCIATIC NERVE BLOCK IN BELOW KNEE SURGERY-A ONE YEAR HOSPITAL BASED DOUBLE BLIND RANDOMIZED CLINICAL TRIALâ€

The popliteal sciatic nerve block is a form of regional anesthesia used for surgeries below the knee.

Profound analgesia during both the operative and post-operative time periods and the avoidance of systemic complications are also potential benefits of the popliteal nerve block.It is also beneficial in medically compromised patients.¹

Regional anaesthesia with long-acting local anaesthetics (LAs), such as ropivacaine, is beneficial for effective postoperative pain control, but the duration of sensory block is still not sufficient to avoid the postoperative use of opioids. Perineural catheters and continuous infusion are an effective alternative to prolong the analgesic effects, but they can present challenges related to patient management, catheter displacement and the potential for increased infection risk.So the use of adjuvants, such as adrenaline, clonidine, opioid and steroids, with local anaesthetics for early onset and for prolonging the duration of blocks has been practiced for many years and remains the subject of much interest.²

Dexmedetomidine, a highly selective alpha-2 adrenergic receptor agonist that has an alpha-2 to alpha-1 selectivity ratio 7 times greater than that of clonidine, has recently been investigated for its analgesic effects and has the potential to become an alternative to clonidine. Dexmedetomidine seems to exhibit synergism with local anaesthetics, prolonging their duration of action.

The clinical evidence for the use of dexmedetomidine as an adjuvant to local anaesthetic for peripheral nerve blocks was limited to few animal and human studies. Many trials of dexmedetomidine as adjuvant to local anaesthetics in Brachial plexus block,TAP block,Femoral block etc have been published,thus prompting a re-examination specifically to assess the role of dexmedetomidine in prolonging the action of Ropivacaine in Popliteal block.³

So in this randomized study,we want to evaluate the effect of Dexmedetomidine in  onset and duration of sensory and motor block as adjuvant to Ropivacaine in popliteal sciatic nerve block.Also its effect on hemodynamic parameters and Post operative pain relief will be studied.