Comparison of the Analgesic Efficacy of Dexmedetomidine and Buprenorphine as adjuvant to 0.5 Percent Levobupivacaine in Ultrasound Guided Supraclavicular Brachial Plexus Block in Patients Undergoing Upper Limb Surgeries-A Prospective Randomized Clinical Study

The brachial plexus nerve block is a novel regional anaesthetic technique which is evolving and flourishing as an adjuvant and sometimes as an alternative to general anaesthesia. Brachial plexus provides a large part of sensory and motor innervation to upper limb, hence, blocking it is an effective method of providing anaesthesia from shoulder to finger tips. It has also been shown to be an attractive option, due to its effectiveness in terms of cost, along with benefit of postoperative analgesia. Several adjuvants can be added to the local anaesthetic to increase the quality and duration of the blockade. Levobupivacaine is an amino-amide long-acting local anaesthetic and the (S)-enantiomer of bupivacaine. It exerts its local anaesthetic effect by blocking voltage-gated sodium channels in the peripheral neurons. Dexmedetomidine a second generation α2 adrenergic receptor specific agent. The increased α2 selectivity results in more predictable and effective sedation and analgesia and fewer side effects. Buprenorphine is a semisynthetic opioid. It has the greater safety margin compared to other classical opioids. It blocks the Na+ channels by binding to the intracellular part of the receptor where the local anaesthetics bind. This study aims to find the analgesic efficacy of buprenorphine and dexmedetomidine as an adjuvant to 0.5% Levobupivacaine in ultrasound guided supraclavicular brachial plexus blocks.