Background and Aims Dexmedetomidine is known to prolong the duration of regional block while its sedative effect when administered perineurally is unknown. We aim to evaluate the effect of perineural Dexmedetomidine on the systemic sedation in patients after axillary brachial plexus block (ABPB).
Methods This prospective randomized control trial includes 78 patients undergoing wrist surgery receiving ABPB. The study was conducted with the approval of Ethics Committee of Riga Stradins University. Patients were randomized into two groups – control (CG) (N=39) and study group (SG) (N=39). Both groups received ABPB with a standard dose of local anaesthetics. The study group also received 100 mcg of dexmedetomidine perineurally. Depth of sedation during surgery was evaluated using electroencephalography with Narcontrend Index (NI) and Ramsay Sedation Scale (RSS). Patient satisfaction with sedation was evaluated using a postoperative survey.
Results During 10 to 60 minutes after ABPB the median RSS was 4 and median NI was between 54 to 69 in SG. Median RSS decreased to 2 and median NI increased to 90 in 90 minutes after ABPB in SG. Patients in the CG had the median RSS of 2 and Narcotrend Index of 97 all throughout surgery. (p=0.001) No significant differences in hemodynamic or respiratory parameters were found between the groups. Patients in the SG expressed satisfaction with quality of sedation and 88.4% noted that the sensation was similar to ordinary sleep.
Conclusions Perineural administration of Dexmedetomidine provides systemic sedation with no effect on hemodynamic or respiratory stability and yields a high level of patient satisfaction.
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