Tramadol sparing effect of dexmedetomidine as an adjuvant with lignocaine in preoperative stellate ganglion block for postoperative pain relief following upper limb surgeries

Abstract

Background:

Recent literature has established the role of stellate ganglion block (SGB) for management of acute postoperative pain. The effects of dexmedetomidine as an adjuvant to lignocaine in a preoperative SGB for postoperative pain relief have not been evaluated so far.

Methods:

The following randomised, double-blinded, control trail included 54 patients scheduled for upper limb orthopaedic surgery under general anaesthesia. Preoperative ultrasound-guided (USG) SGB was performed in all patients. Group I (n = 18) received 3.5 mL of a solution (3 mL 2% lignocaine + 0.5 μg/kg dexmedetomidine for SGB) and 15 mL of intravenous (IV) normal saline (NS). Group II (n = 18) received 3.5 mL of a solution (3 mL 2% lignocaine + 0.5 mL NS for SGB) and 15 mL of IV NS. Group III (n = 18) received 3.5 mL of a solution (3 mL 2% lignocaine + 0.5 mL of NS for SGB) and 0.5 μg/kg dexmedetomidine in 15 mL of IV NS. Postoperatively tramadol consumption and Visual Analogue Scale (VAS) score were recorded up to 48 hours.

Results:

The cumulative tramadol consumption at the end of 48 hours (p = 0.01) was significantly reduced in the group I as compared to group II. In group I, postoperative VAS at rest was significantly reduced up to 12 hours postoperatively as compared to group II (p = 0.05). The cumulative tramadol consumption was not reduced significantly in group III compared to group II (p = 0.51).

Conclusion:

Dexmedetomidine as an adjuvant to SGB along with lignocaine produced a significant tramadol sparing effect and superior analgesia as compared to IV dexmedetomidine and control group.¹