A study to see whether we can increase the pain-free period in upper limb surgeries with regional anaesthesia block by adding dexmedetomidine to low-dose levobupivacaine

INTERVENTION: 60 ASA I and II patients aged between 18 to 60 years of either sex undergoing elective upper limb surgery lasting more than 30 minutes were included in the study. They were divided into two groups of 30 each in a randomised double‐blind method. The patients underwent supraclavicular brachial plexus block under ultrasound guidance. Group L was given a nerve block with 20 ml of 0.25% levobupivacaine and 1 ml saline and group D received 20 ml of 0.25% levobupivacaine with 0.5 mcg/kg of dexmedetomidine (diluted to a volume of 1 ml). Onset time and duration of sensory and motor blockade and time to first rescue analgesia and hemodynamic variations were recorded. CONDITION: Elective upper limb surgery ; Surgery PRIMARY OUTCOME: ; 1. Sensory block assessed by atraumatic pinprick test using a three‐point scale at 3, 6, 12, 15, 18, 21, 24, 27, 30 min; 2. Motor block assessed using the Modified Bromage three‐point scale at 5, 10, 15, 20, 25 and 30 min, and thereafter every 15 min for 2 h and then 30 min until the block effect has resolved; 3. Sedation score assessed by the Ramsay sedation scale at 0, 5, 10, 15, 20, 25, 30 min; 4. Pain assessed using a visual analogue scale (VAS) 0‐10 at 0, 5, 10, 15, 20, 30 min, then hourly for 24 hours; SECONDARY OUTCOME: ; 1. Duration of analgesia measured using visual analogue scale hourly until the patient complains of pain over 24 h; 2. Adverse events measured including hypotension, bradycardia, drop‐in saturation, recorded by continuous monitoring for 24 h; INCLUSION CRITERIA: 1. Undergoing elective upper limb surgery lasting more than 30 minutes 2. Aged 18‐60 years 3. American Society of Anesthesiologists Classification (ASA) I and II