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Dexmedetomidine has been proved to be safe and efficacious in sustaining the duration of peripheral nerve blocks.
Various modalities provide postoperative
analgesia in breast cancer surgeries for example opiates, nonsteroidal
anti-inflammatory agents, wound infiltration with local anaesthetic agents,
thoracic epidural, and paravertebral blocks. This randomized study explored the
efficacy of dexmedetomidine regarding prolonged duration and improved quality
of postoperative analgesia further supporting bupivacaine in pecs I and II
blocks.
Dexmedetomidine has been proved to be safe and
efficacious in sustaining the duration of peripheral nerve blocks. This study
compared the duration, quality of postoperative analgesia, hemodynamic
stability, and patient's satisfaction with the addition of dexmedetomidine to
bupivacaine versus plain bupivacaine in pectoral nerve block (Pecs) type I and
II in breast surgeries.
The prospective randomized double-blind study
was executed in 60 American Society of Anesthesiologists grade I–III female
patients, within the age group of 18 to 70 years, randomly allocated into two
equal groups. In Group A, 10 ml 0.25% bupivacaine for pecs I block was given to
the patients and in Group B, 20 ml 0.25% bupivacaine for pecs II block.
Group B received 10 ml 0.25% bupivacaine with dexmedetomidine for pecs I block
and 20 ml 0.25% bupivacaine with dexmedetomidine in pecs II block, keeping a
total dose of dexmedetomidine of 1 μg/kg body weight and same volume in both
the groups.
In Group B, Numerical rating scores at rest and
on the abduction of the arm were significantly lower. The complete analgesia in
the dexmedetomidine group (1024.0 ± 124.9 min) increased to 40% as compared to
plain bupivacaine (726.4 ± 155.3 min; P < 0.001). Total consumption of
injection diclofenac sodium in 24 h was 23% less in Group B (77.5 ± 13.6 mg) as
opposed to Group A (100.0 ± 35.9 mg, P = 0.003). Better patient
satisfaction score was observed in the dexmedetomidine group. No adverse
effects were noted in either group.
Dexmedetomidine as an adjunct to bupivacaine
helps prolong the duration and improves the quality of postoperative analgesia
in pecs I and II block without serious side effects.
Journal of Anaesthesiology Clinical Pharmacology
A comparative study to assess the quality of analgesia of bupivacaine and bupivacaine with dexmedetomidine in ultrasound-guided pectoral nerve block type I and II in breast surgeries
Shaiqa Manzoor et al.
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