XXXX as an adjuvant in axillary brachial plexus block for below elbow orthopedic surgeries: A comparison between local and systemic administration.

@entity1 @entity390 @entity1337 @entity391 @entity3481 @entity1341 @entity1338 @entity616
BACKGROUND: Axillary brachial plexus block for below elbow orthopedic surgery provides a safe and low-cost technique with the advantage of prolonged postoperative @entity1337 . @entity1338 , with selective partial agonist activity on a2 adrenergic receptors, has significantly demonstrated its role in this regard as an adjuvant to local anesthetics. The current study compares the locally administered @entity1338 with systemically administered control group in terms of onset and duration of @entity616 , motor block, and @entity1337 ; hemodynamic variability; sedation; and other side effect profile. MATERIALS AND METHODS: Seventy @entity1 (ASA I or II) scheduled for below elbow orthopedic surgeries were randomly allocated in equal numbers to receive either 30 ml of 0.5% plain @entity1341 with 150  g (1 ml) of inj. @entity1338 locally in the axillary sheath and 1 ml of normal saline (NS) subcutaneously (Group L) or 30 ml of 0.5% plain @entity1341 with 1 ml of NS locally and 150  g (1 ml) of inj. @entity1338 subcutaneously (Group S). Standard monitoring of vital parameters was done. Duration of @entity3481 , @entity1337 , hemodynamic changes, and any adverse effects were observed and recorded for different duration up to 24 h. RESULTS: Duration of @entity616 (625    35 min), motor block (690    38 min), and @entity1337 (930    45 min) was significantly longer in Group L than in Group S [ @entity616 (480    30 min), motor block (535    25 min), and @entity1337 (720    30 min)] (P < 0.05). Significant alteration of heart rate, systolic blood pressure and diastolic blood pressure, and mean arterial pressure in Group S was observed compared to Group L (P < 0.05). Side effects like @entity390 and @entity391 were comparable, but highly significant sedation score (  (2) = 47.75 and 49.51 at 120 and 240 min, respectively; P < 0.01) was observed between the two groups. CONCLUSION: Compared to systemic administration, local @entity1338 as an adjuvant in axillary block resulted in significant prolongation of duration of sensory and motor blockade, and @entity1337 without any hemodynamic alteration, probably by locally mediated mechanism of action.
