Retrospective comparison of the anesthetic effects of bupivacaine and bupivacaine+dexmedetomide on infraclavicular brachial plexus block in upper extremity surgery

We aimed to compare the anesthetic effects of dexmedetomidine added to bupivacaine as an adjuvant in infraclavicular brachial plexus block applied for anesthesia in patients with hand and forearm surgery, in this retrospective study. After ethics committee approval, 84 patients, aged between 18-70 years, who underwent elective hand and forearm surgery, had American Society of Anesthesiologists (ASA) classification I-II (Annex 1), and were anesthetized with ultrasound-guided infraclavicular brachial plexus block were included in the study. Group B (n=42): 20 ml bupivacaine 0.5%+20 ml SF, Group (B+D) (n:42): 20ml bupivacaine 0.5% + 1mcg/kg dexmedetomidine was selected from the patients who underwent block. Demographic information (name-surname, protocol number, weight, height, age, body mass index, comorbidity, ASA score) of the patients were taken from the preoperative anesthesia evaluation form and recorded. From the information recorded in the patient follow-up form, peak heart rate, mean arterial pressure recorded at 0. min, 10. min, 20. min, 30. min, 1st hour, 2nd hour, 4th hour, 8th hour, 12th hour, oxygen saturation percentage, Visual Analogue Scale (VAS) scores, pinprick test score and bromage score were recorded as study data. Additional analgesic drugs administered to the patients and recorded side effects, operation time, complications, patient and surgeon satisfaction were recorded. Compared to group B, the onset time of sensory and motor blockade was statistically significantly earlier and the duration of sensory block, motor block and analgesia was statistically significantly longer in group B+D (p<0.05). In Group B+D, VAS score was statistically significantly lower at 10th, 20th, 8th and 12th hours (p<0.05). We found that the addition of 1mcg/kg dexmedetomidine to 20 ml of 0.5% bupivacaine in infraclavicular brachial plexus block accelerated the onset of sensory and motor block, and prolonged the duration of motor, sensory block and analgesia.