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Efficacy and Safety of Dexmedetomidine to Bupivacaine in Supraclavicular Brachial Plexus Block

Not Applicable
Completed
Conditions
Dexmedetomidine
Bupivacaine
Supraclavicular Brachial Plexus Block
Interventions
Registration Number
NCT06020781
Lead Sponsor
Kafrelsheikh University
Brief Summary

The study aims to evaluate the analgesic efficacy and safety of addition of 1µg/kg dexmedetomidine to 20ml bupivacaine compared to 20ml and 30ml bupivacaine without additives in ultrasound-guided supraclavicular brachial plexus block for anesthesia.

Detailed Description

Dexmedetomidine, a highly selective α2 adrenergic agonist, has been used as an adjuvant to local anesthetics. Various clinical trials performed have shown dexmedetomidine to be safe when used as an adjuvant to local anesthetic in subarachnoid, caudal, and epidural Different doses of dexmedetomidine are commonly used as an additive in Ultrasound-guided supraclavicular brachial plexus block, 1 μg/kg and 2 μg/kg in which a high dose of dexmedetomidine does not prolong the duration of analgesia, but it is associated with lower heart rate and blood pressure. Incidence of hypotension and bradycardia is also more. Hence, a lower dose of 1 μg/kg dexmedetomidine is a good balance between safety and efficacy

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
75
Inclusion Criteria
  • American Society of Anesthesiologist (ASA) grade I or II patients
  • both sexes
  • scheduled for elective upper limb surgery below mid-humerus level under Ultrasound -guided Supraclavicular brachial plexus block .
Exclusion Criteria
  • with pre-existing peripheral neuropathy of upper limb.
  • Bleeding disorders.
  • Infection at injection site.
  • Untreated pneumothorax.
  • Patients on adrenoreceptor agonist or antagonist therapy.
  • History of severe cardiac,.respiratory, hepatic, or renal disease.
  • pregnancy and known hypersensitivity to the study drugs.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Bupivacaine and Dexmedetomidinebupivacaine and dexmedetomidine.Patients will receive ultrasound-guided Supraclavicular brachial plexus block with 20 ml bupivacaine 0.5% + 1 μg/kg dexmedetomidine.
20 ml Bupivacaine without additivesbupivacaine onlyPatients will receive ultrasound-guided Supraclavicular brachial plexus block with 20 ml bupivacaine 0.5% without additives.
30 ml bupivacaine without additivesbupivacainePatients will receive ultrasound-guided Supraclavicular brachial plexus block with 30 ml bupivacaine 0.5% without additives as a control group.
Primary Outcome Measures
NameTimeMethod
Success rate.30 minutes after block performance

Sensory and motor block evaluation will be done every 3 min after giving the block until complete sensory and motor block or 30 min, whichever will be earlier.

Secondary Outcome Measures
NameTimeMethod
Total pethidine consumption.24 hours postoperative.

Visual analog scale ≥ 4 indicates the analgesic requirements. The patient will be given supplementary pethidine I.V. injection in a dose of 0.5 mg as rescue analgesia. Total pethidine consumption postoperative in the 1st 24 hours will be measured.

Pain score.24 hours postoperative.

Pain score will be measured by visual analogue scale (VAS) at 30 minutes and then at 2, 4, 6, 12, 18 and 24 hours postoperative.

The VAS consists of a 10cm line, with two end points representing 0 (no pain) and 10 (pain as bad as it could possibly be).

Mean arterial blood pressureFrom preoperatively till the end of surgery

Mean arterial blood pressure from preoperatively, after block, then every 15 minutes intraoperative till the end of surgery.

Heart rateFrom preoperatively till the end of surgery

Heart rate from preoperatively, after block, then every 15 minutes intraoperative till the end of surgery.

Postoperative side effects.24 hours postoperative

Complication related to the block or adverse events of the administered drugs.

Trial Locations

Locations (1)

Kafrelsheikh University

🇪🇬

Kafr Ash Shaykh, Kafrelsheikh, Egypt

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