A randomized controlled trial to study effectiveness of nalbuphine vs dexmedetomidine as an adjuvant to local anaesthesia in patients undergoing Upper limb surgeries under ultrasound guided supraclavicular block.

The study is randomized double blind, parallel group control trial.

The selected patients will be divided into three groups of 32 patients in each group. Group A: Receives ropivacaine plain 0.5 % 10 ml +lignocaine plain 2 % 5 ml +10ml Normal saline (NS), Group B: Receives ropivacaine plain 0.5 % 10 ml +lignocaine plain 2 % 5 ml + 50 microgram dexmedetomidine diluted in 10 ml NS ,Group C: Receive ropivacaine plain 0.2 % 10 ml +lignocaine plain 2 % 5 ml + Nalpbuphine 10 mg diluted in 10 ml NS.

On the morning of surgery computer generated randomization will be conducted and patient will be given local anaesthetic solution as per randomization. The local anaesthetic solution, with or without adjuvant, will be prepared by a different anaesthesiologist. Thus, the team giving brachial plexus block will be unaware of the local anaesthetic solution used, with or without adjuvant. Patient will also be unaware of the local anaesthetic solution, with or without adjuvant used for the block.

Sensory and motor assessment will performed immediately after positioning the patient supine and every 5 minutes to check for onset of sensory and motor blockade.

In the post operative period, Basal hemodynamics (HR, NIBP) and NRS score for pain, SpO2, sensory and motor weakness, requirement of rescue analgesia, nausea, vomiting will be noted during following intervals: 0-2 hours, 4-6 hours, 6-12 hours, 12-24 hours. Any other complications will also be noted.