Sonika Panchariya¹, Rahul Kumar Chaudhary¹*, Mallika Rayamajhi² and Raveesh Mishra²

¹Department of Anesthesiology and Critical Care, Birat Medical College Teaching Hospital, Tankisinuwari, Morang, 56613, Nepal
²Department of Anesthesiology and Critical Care, Nepalese Army Institute of Health Sciences, Kathmandu, 44600, Nepal

*Corresponding Author: Rahul Kumar Chaudhary, Department of Anesthesiology and Critical Care, Birat Medical College Teaching Hospital, Tankisinuwari, Morang, 56613, Nepal.

Received: September 04, 2025; Published: October 17, 2025

Abstract

Background: Supraclavicular brachial plexus block (SCBPB) is a preferred alternative to general anesthesia for upper limb surgeries, offering reduced stress responses and prolonged postoperative analgesia. Ultrasound guidance enhances its safety and efficacy. Dexmedetomidine, a potent α₂-agonist, has shown promise as an adjuvant to local anesthetics by prolonging block duration and improving analgesia. This study compared the effects of adding dexmedetomidine to 0.25% bupivacaine in SCBPB on sensory/motor block onset/duration and postoperative analgesia.

Methods: In this randomized controlled trial, 50 patients undergoing upper limb surgeries below the mid-humerus were allocated into two groups (n = 25 each). Group A received 20 mL of 0.25% bupivacaine, while Group B received 20 mL of 0.25% bupivacaine with 30 µg dexmedetomidine. Ultrasound-guided SCBPB was performed, and outcomes included onset/duration of sensory/motor blockade, postoperative analgesia duration (assessed via Numerical Rating Scale, NRS), and hemodynamic stability. Adverse events were recorded.

Results: Group B demonstrated significantly faster sensory (5.11 vs. 8.01 min, p < 0.0001) and motor block onset (7.80 vs. 11.55 min, p = 0.0005) compared to Group A. The duration of sensory (895.40 vs. 642.80 min) and motor block (777.20 vs. 566.20 min) was prolonged in Group B (p < 0.0001). Postoperative analgesia lasted longer in Group B (849.20 vs. 594.80 min, p < 0.0001). Hemodynamic parameters remained stable, with no significant intergroup differences. Two cases of transient bradycardia occurred in Group B, requiring atropine.

Conclusion: Dexmedetomidine (30 µg) as an adjuvant to 0.25% bupivacaine in SCBPB accelerates block onset, extends sensory/motor blockade, and prolongs postoperative analgesia without significant adverse effects. It is a safe and effective option for enhancing brachial plexus block outcomes.

 Keywords: Bupivacaine; Dexmedetomidine; Supraclavicular Brachial Plexus Block; Ultrasound

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Citation

Citation: Rahul Kumar Chaudhary., et al. “Supraclavicular Brachial Plexus Block with and without Dexmedetomidine as an Adjuvant to 0.25% Bupivacaine: A Randomized Controlled Trial”.Acta Scientific Medical Sciences 9.11 (2025): 30-43.

Copyright

Copyright: © 2025 Rahul Kumar Chaudhary., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.