Dexmedetomidine as an adjuvant to ropivacaine prolongs peripheral nerve block: a volunteer study

Br J Anaesth. 2013 Mar;110(3):438-42. doi: 10.1093/bja/aes400. Epub 2012 Nov 15.

Abstract

Background: Dexmedetomidine is an α-2-receptor agonist which might be used as an additive to local anaesthetics for various regional anaesthetic techniques. We therefore designed this prospective, double-blinded, controlled volunteer study to investigate the effects of dexmedetomidine as an adjuvant to ropivacaine on peripheral nerve block.

Methods: Ultrasound-guided ulnar nerve block (UNB) was performed in 36 volunteers with either 3 ml ropivacaine 0.75% (R), 3 ml ropivacaine 0.75% plus 20 µg dexmedetomidine (RpD), or 3 ml ropivacaine 0.75% plus systemic 20 µg dexmedetomidine (RsD). UNB-related sensory and motor scores were evaluated.

Results: Sensory onset time of UNB was not different between the study groups, whereas motor onset time was significantly faster in Group RpD when compared with the other study groups [mean (sd)] [21 (15) vs 43 (25) min in Group RsD and 47 (36) min in Group R, P<0.05 Group RpD vs other groups]. The duration of sensory block was 350 (54) min in Group R, 555 (118) min in Group RpD, and 395 (40) min in Group RsD (P<0.01 Group RpD vs other groups, P<0.05 Group RsD vs Group R). Motor block duration was similar to the duration of sensory block.

Conclusions: A profound prolongation of UNB of ∼60% was detected with perineural dexmedetomidine when added to 0.75% ropivacaine. The systemic administration of 20 µg dexmedetomidine resulted in a prolongation of ∼10% during UNB with 0.75% ropivacaine. Eudra-CT No.: 2012-000030-19.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adjuvants, Anesthesia* / adverse effects
  • Adolescent
  • Adrenergic alpha-Agonists* / adverse effects
  • Adult
  • Amides* / adverse effects
  • Anesthetics, Local* / adverse effects
  • Dexmedetomidine* / adverse effects
  • Double-Blind Method
  • Heart Rate / drug effects
  • Humans
  • Male
  • Nerve Block / methods*
  • Peripheral Nerves*
  • Prospective Studies
  • Ropivacaine
  • Ulnar Nerve
  • Ultrasonography, Interventional
  • Young Adult

Substances

  • Adjuvants, Anesthesia
  • Adrenergic alpha-Agonists
  • Amides
  • Anesthetics, Local
  • Dexmedetomidine
  • Ropivacaine