Dexmedetomidine Versus Nalbuphine as Adjuvants to 0.5% Ropivacaine in Ultrasound-Guided Supraclavicular Brachial Plexus Block: A Prospective Randomised Controlled Trial.

BACKGROUND

Dexmedetomidine and nalbuphine are used as adjuvants to local anesthetics in regional anesthesia. This study aims to compare their efficacy and safety in supraclavicular brachial plexus block.

METHODS

In this prospective, double-blind randomized study, 60 patients undergoing upper limb surgery were divided into two groups. Group D received ropivacaine with dexmedetomidine, and Group N received ropivacaine with nalbuphine. Parameters such as onset and duration of sensory and motor block, sedation, rescue analgesia requirement, hemodynamic variables and side effects were recorded.

RESULTS

Group D demonstrated significantly faster onset and prolonged duration of sensory and motor blocks. Time to first rescue analgesia was significantly longer and the number of rescue doses was fewer in Group D. Sedation scores were higher in the early postoperative period in Group D. Bradycardia and hypotension were more frequent in Group D, while Group N exhibited stable hemodynamics but experienced higher incidence of nausea and pruritus compared to Group D.

CONCLUSION

Dexmedetomidine provides superior block characteristics and prolonged analgesia but with more hemodynamic effects. Nalbuphine is safer hemodynamically but with more nausea and pruritus.