Comparison of Two Different Doses of Dexmedetomidine Added to Lignocaine in Patients Posted for Upper Limb Orthopedic Surgery Under Intravenous Regional Anaesthesia

Rom J Anaesth Intensive Care. 2022 Dec 29;28(2):63-70. doi: 10.2478/rjaic-2021-0011. eCollection 2021 Dec.

Abstract

Background: Intravenous regional anaesthesia (IVRA) is a dependable and safe technique specific anatomical knowledge is not required. The present research aimed to evaluate the effects of dexmedetomidine in combination with lidocaine and to compare the onset of motor and sensory block and evaluate the postoperative analgesia, as well as the side effects.

Methods: A prospective randomized controlled double-blinded study was conducted on 90 patients assigned randomly into three equal groups,. Group (I) received only lidocaine 2% 3mg/kg for Bier block. Group (II) received lidocaine 2% 3mg/kg with plus dexmedetomidine 0.25 μg/kg for Bier block. Group (III) received lidocaine 2% 3mg/kg plus dexmedetomidine 0.5 μg/kg for Bier block.

Results: Postoperative VAS was lower in a statistically significant way in the group III patients than those in groups I and II and this followed a reduction in the analgesic requirement in group III.

Conclusions: The combination of dexmedetomidine 0.5 μg/kg with lidocaine 2% (3mg/kg) when applying intravenous regional anaesthesia (IVRA) allowed improved postoperative analgesia. Furthermore, the combination reduced onset time, extended recovery time for sensory/motor blocks and did not affect the incidence of intra-operative and postoperative complications.

Keywords: Dexmedetomidine; intravenous regional anaesthesia; lignocaine; upper limb orthopedic surgery.