supraclavicular brachial plexus block with Levobupivacaine and Dexmeditomidine

Completed

• Conditions: American society of anesthesiologists (ASA) physical status: I-II

• Registration Number: CTRI/2017/03/008199
• Lead Sponsor: NA

Brief Summary

Brachialplexus block at various levels has been in use for upper extremity surgeriessince its description by Kulenkampff in 1928(1). Supraclavicularapproach to brachial plexus block has remained the most popular because of itsubiquitous application for upper extremity surgeries, predictability andcomplete anesthesia of upper limb(2). After a briefperiod of disfavor due to risk of pneumothorax, application of nervestimulation and recent introduction of ultrasonography for localization ofbrachial plexus has rekindled anesthesiologist’s interest in supraclavicularblock(3).

Althoughbupivacaine remains commonly used local anesthetic for performance of nerveblocks due to its long duration of action and good motor blockade, concernsabout toxicity at higher doses remain. Levobupivacaine, a less cardiotoxic s- isomerof bupivacaine is proved to be similar to bupivacaine if not forpharmaco-economic considerations hence proposed as a safer alternative to theformer for performance of nerve blocks(4).

Evenwith increasing use of perineural catheters for pain relief, manyanesthesiologists still continue to use single-shot techniques for nerve blocks.This has led to the practice of using additives to local anesthetics with intentto improve the quality and duration of block. Among others, selective α2agonist dexmedetomidine has been studied for its ability to affect the axillarybrachial plexus block characteristics. Intravenous administration of dexmedetomidinealong with spinal anesthesia has been found to prolong the duration of block(5–7). Few studieshave evaluated the effect of intravenous dexmedetomidine on brachial plexusblock(8). Albeit theavailability of studies on the effect of dexmedetomidine on axillary brachialplexus block performed by nerve stimulator guidance with Levobupivacaine (9), no study hasevaluated the effect of dexmedetomidine on ultrasound guided supraclavicularbrachial plexus block with Levobupivacaine.

Detailed Description

Not available

Study Timeline

• Study Start: 2014-10-09
• Last Update Posted: 2017-10-03

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 120

Inclusion Criteria

1.Age: 18 – 60 years 2.American society of anesthesiologists (ASA) physical status: I-II 3.Elbow, forearm and hand surgeries.

Exclusion Criteria

1.Patient refusal for procedure 2.Any bleeding disorder or patients on anticoagulants 3.Neurological deficits involving brachial plexus 4.Body weight less than 50 Kg 5.Patients with known allergy to local anaesthetics 6.Local infection at injection site 7.History of seizures 8.History of pneumothorax 9.Pregnant women 10.ASA grade III-IV.

Study & Design

• Study Type: Interventional
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
1.The onset of sensory and motor block	Time interval between administration of study drug to loss of pin prick sensation in all 4 nerve territories. Time interval between of administration of study drug to a motor score of 2 or lower according to modified Bromage scale in all 4 nerve territories.Time interval between loss of pin prick sensation to reappearance of sensation in all 4 nerve territories. | Time interval between attainment of ≤Grade 2 motor block to complete recovery of motor power in all 4 nerve territories.
2.Duration of sensory/ motor blockade	Time interval between administration of study drug to loss of pin prick sensation in all 4 nerve territories. Time interval between of administration of study drug to a motor score of 2 or lower according to modified Bromage scale in all 4 nerve territories.Time interval between loss of pin prick sensation to reappearance of sensation in all 4 nerve territories. | Time interval between attainment of ≤Grade 2 motor block to complete recovery of motor power in all 4 nerve territories.

Secondary Outcome Measures

Name	Time	Method
Sedation score	Complications / side effects if any

Trial Locations

Locations (1)

Kasturba Hospital, Manipal; 🇮🇳 Udupi, KARNATAKA, India

Kasturba Hospital, Manipal

🇮🇳Udupi, KARNATAKA, India

Dr Bhumireddy Suneel reddy

Principal investigator

07760003883

suneelreddy547@gmail.com