The effect of perineurial Dexmedetomidine on the systemic sedation in axillary brachial plexus block

Mareks Andruškevičs, Rihards Pēteris Ročāns, Agnese Ozoliņa, Biruta Mamaja, Diana Ramane

Research output: Contribution to conferenceAbstractpeer-review

Abstract

Objectives: Dexmedetomidine is known to prolong the duration of regional block while its
systemic sedation effect is unknown when administered perineurally alongside local
anaesthetics. We aim to evaluate the effect of perineural Dexmedetomidine on the systemic
sedation in patients after axillary brachial plexus block.
Materials and Methods: A prospective randomized control trial included 80 patients
undergoing wrist surgery receiving axillary plexus brachialis block. All patients were older
than 18 years and belonged to ASA I-II class. Patients were randomized into two groups -
control (N=40) and study group (N=40). The control group received axillary plexus brachialis
block with 10 ml of 2% Lidocaine and 20 ml of 0,5% Bupivacaine. The study group received
100 mcg of dexmedetomidine perineurally. Ultrasound guidance and neurostimulation
techniques were used to perform the block. All patients had electroencephalography
monitoring (Narcotrend Index) alongside standard monitoring to assess the depth of sedation
intraoperatively. Ramsay Sedation Scale (RSS) was used to evaluate primary outcome effect
on the systemic sedation of Dexmedetomidine. A postoperative survey was also conducted to
evaluate secondary patient satisfaction with sedation during surgery.
Results: In total, 80 patients (38 males, 42 females) were analysed. The mean age was 49,5 ±
14,9 years. There was no statistically significant difference in age or sex between the groups.
The median RSS was 4 and median Narcotrend Index was between 54 to 69 in the study
group 10 to 60 minutes after axillary plexus brachialis block. The median RSS decreased to 2
and median Narcotrend Index increased to 90 in 90 minutes after the block. In contrast,
patients in the control group had the median RSS 2 and Narcotrend Index 97 during surgery.
Both analysed values of RSS and Narcotrend Index significantly differed between the groups
(p< 0.0001). When analysing hemodynamic or respiratory parameters, no significant
difference was found between the groups. The survey revealed that 37 (92.5 %) in study
group and only 4 (12.5 %) in control group fell asleep during surgery (p < 0.0001). Patients
in the study group expressed a high level of satisfaction with sleep quality and 86.5% of them
noted that the sensation was similar to ordinary sleep at home.
Conclusions: Perineural administration of Dexmedetomidine provides systemic sedation
without effect on hemodynamic or respiratory stability with a high level of patient
satisfaction.
Original languageEnglish
Pages100-101
Number of pages2
Publication statusPublished - 2021
Event10th International Baltic Congress of Anaesthesiology, Intensive Care and Pain Management (BALTANEST) - Virtual
Duration: 7 Oct 20218 Oct 2021
Conference number: 10

Congress

Congress10th International Baltic Congress of Anaesthesiology, Intensive Care and Pain Management (BALTANEST)
Abbreviated titleBALTANEST
Period7/10/218/10/21

Field of Science*

  • 3.2 Clinical medicine

Publication Type*

  • 3.4. Other publications in conference proceedings (including local)

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