Comparison of dexmedetomidine and epinephrine as an adjuvant to 1% mepivacaine in brachial plexus block
Korean Journal of Anesthesiology 2014³â 66±Ç 4È£ p.283 ~ p.289
¼ÛÀåÈ£(Song Jang-Ho) - Inha University School of Medicine Departments of Anesthesiology and Pain Medicine
(Shim Hee-Yong) - Inha University School of Medicine Departments of Anesthesiology and Pain Medicine
À̵¿ÁÖ(Lee Tong-Joo) - Inha University School of Medicine Department of Orthopedic Surgery
Á¤Á¾±Ç(Jung Jong-Kwon) - Inha University School of Medicine Departments of Anesthesiology and Pain Medicine
Â÷¿µ´ö(Cha Young-Deog) - Inha University School of Medicine Departments of Anesthesiology and Pain Medicine
À̵ÎÀÍ(Lee Doo-Ik) - Inha University School of Medicine Departments of Anesthesiology and Pain Medicine
±è°Ç¿ì(Kim Gun-Woo) - Inha University School of Medicine Departments of Anesthesiology and Pain Medicine
ÇÑÁ¤¿í(Han Jeong-Uk) - Inha University School of Medicine Departments of Anesthesiology and Pain Medicine
Abstract
Background: Dexmedetomidine extends the duration of nerve block when administered perineurally together with local anesthetics by central and/or peripheral action. In this study, we compared the duration of nerve block between dexmedetomidine and epinephrine as an adjuvant to 1% mepivacaine in infraclavicular brachial plexus block.
Methods: Thirty patients, scheduled for upper limb surgery were assigned randomly to 3 groups of 10 patients each. We performed brachial plexus block using a nerve stimulator. In the control group (group C), patients received 40 ml of 1% mepivacaine. In group E, patients received 40 ml of 1% mepivacaine containing 200 ¥ìg of epinephrine as an adjuvant. In group D, patients received 40 ml of 1% mepivacaine containing 1 ¥ìg/kg of dexmedetomidine as an adjuvant. Sensory block duration, motor block duration, time to sense pain, and onset time were assessed. We also monitored blood pressure, heart rate, oxygen saturation and bispectral index.
Results: In group D and group E, sensory block duration, motor block duration and time to sense first pain were prolonged significantly compared to group C. However, there was no significant difference between group D and group E.
Conclusions: Perineural 1 ¥ìg/kg of dexmedetomidine similarly prolonged nerve block duration compared to 200 ¥ìg of epinephrine, but slowed heart rate. Thus, dexmedetomidine is expected to be a good alternative as an adjuvant to local anesthesia in patients who are cautioned against epinephrine.
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Brachial plexus, Dexmedetomidine, Epinephrine
KMID :
0356920140660040283
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