# Dexmedetomidine Versus Nalbuphine as Adjuvants to 0.5% Ropivacaine in Ultrasound-Guided Supraclavicular Brachial Plexus Block: A Prospective Randomised Controlled Trial

## TL;DR

This study compares dexmedetomidine and nalbuphine as additives to ropivacaine for brachial plexus block, finding differences in effectiveness and side effects.

## Contribution

The study provides a direct comparison of two adjuvants in regional anesthesia for upper limb surgery, highlighting their distinct efficacy and safety profiles.

## Key findings

- Dexmedetomidine provides faster onset and longer duration of sensory and motor blocks.
- Dexmedetomidine increases sedation and hemodynamic side effects like bradycardia and hypotension.
- Nalbuphine is associated with more nausea and pruritus but maintains stable hemodynamics.

## Abstract

Background: Dexmedetomidine and nalbuphine are used as adjuvants to local anesthetics in regional anesthesia. This study aims to compare their efficacy and safety in supraclavicular brachial plexus block.

Methods: In this prospective, double-blind randomized study, 60 patients undergoing upper limb surgery were divided into two groups. Group D received ropivacaine with dexmedetomidine, and Group N received ropivacaine with nalbuphine. Parameters such as onset and duration of sensory and motor block, sedation, rescue analgesia requirement, hemodynamic variables and side effects were recorded.

Results: Group D demonstrated significantly faster onset and prolonged duration of sensory and motor blocks. Time to first rescue analgesia was significantly longer and the number of rescue doses was fewer in Group D. Sedation scores were higher in the early postoperative period in Group D. Bradycardia and hypotension were more frequent in Group D, while Group N exhibited stable hemodynamics but experienced higher incidence of nausea and pruritus compared to Group D.

Conclusion: Dexmedetomidine provides superior block characteristics and prolonged analgesia but with more hemodynamic effects. Nalbuphine is safer hemodynamically but with more nausea and pruritus.