Does Patient-Controlled Infraclavicular Perineural Dexmedetomidine Increase the Duration of Postoperative Analgesia?

Abstract

Objective: Peripheral nerve blocks are now used widely for postoperative analgesiaand peripheral nerve catheters are widely utilized. Objective of this study was toinvestigate effect of perineural infusion of dexmedetomidine on the duration ofpostoperative analgesia retrospectively.Material & Methods: A total of 60 patients aged between 18 and 65 years wereincluded in the study. Group 1 received infraclavicular patient-controlled perineuralbupivacaine (0.1 %). Group 2 received infraclavicular patient-controlled perineuralbupivacaine (0.1 %) + dexmedetomidine (200 mic/100 cc). Blood pressure, pulse,peripheral oxygen saturation modified ramsay sedation scale, visual pain scores, totalamount of analgesics were recorded at the 0, 30, 60, 90 minutes and 2, 4, 6, 8, 12,24 hours.Results: Systolic blood pressure was higher in Group 1 at the hour 6 (p: 0.007).Whereas, diastolic blood pressure was higher in Group 1 at the hours 4 and 6 (p:0.000, p: 0.003). Heart rate was found to be higher in Group 2 at the hours 8, 12 and24 (p: 0.004, p: 0.002, p: 0.002). Patients in Group 1 were found to significantly feelpain and need analgesics at the hours 4 and 6 (p: 0.002, p< 0.05). The mean numberof patient requests for analgesia was 5.8±1.4 times in Group 1 and 2.2±0.4 in Group2 (p<0,05). None of the patients developed sedation/neurological deficits.Conclusion: Perineural infusion of dexmedetomidine combined with bupivacainewas found to increase the duration of postoperative analgesia, reduce 24-hour need for analgesia and have not any adverse efect at low doses.