Effect of Adding Dexmedetomidine to Lidocaine in the Supraclavicular Block Technique in Patients Candidate for Upper Extremity Surgery: A Randomized Controlled Clinical Trial

Bahram Naderi Nabi, Abbas Sedighinejad, M. Soleymanha, Samaneh Ghazanfar Tehran, Zahra Atrkarroushan, A. Mirbolook, M. Habibi, M. Haghighi
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Abstract

Background: Various drugs are used as adjuvants to improve the quality of supraclavicular block method. Objective: This study aims to investigate the effect of adding dexmedetomidine to lidocaine in the supraclavicular block method in patients candidate for upper extremity surgery. Methods: This double-blind randomized controlled clinical trial was conducted on 61 patients candidate for upper extremity fracture surgery receiving the supraclavicular block method from 2017 to 2018. They were randomly divided into two groups of lidocaine-normal saline (30 mL of 1.5% lidocaine plus normal saline) and lidocaine-dexmedetomidine (30 mL of 1.5% lidocaine plus 1 μg/kg of dexmedetomidine). The supraclavicular block characteristics and intraoperative hemodynamic changes were measured. Results: There was no statistically significant difference between the two groups regarding the demographic factors. The mean age of patients was 43.09±10.92 years, and most of them were male. The mean onset time of sensory-motor blockade was faster and the duration of sensory-motor blockade and analgesia were longer in the lidocaine-dexmedetomidine group than in the other group. These differences were statistically significant. There was significant differences in hemodynamic parameters among nine assessment times in each group and between the two groups. Conclusion: Adding dexmedetomidine to lidocaine in the supraclavicular block method accelerates the blockade onset and increases the duration of blockade and analgesia after surgery without causing any considerable side effects.
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右美托咪定与利多卡因联合应用锁骨上阻滞技术对上肢手术患者的影响:一项随机对照临床试验
背景:多种药物作为佐剂用于提高锁骨上阻滞法的质量。目的:探讨右美托咪定与利多卡因联合应用锁骨上阻滞治疗上肢手术患者的效果。方法:对2017 - 2018年61例上肢骨折手术候诊患者采用锁骨上阻滞法进行双盲随机对照临床试验。随机分为利多卡因-生理盐水组(1.5%利多卡因加生理盐水30 mL)和利多卡因-右美托咪定组(1.5%利多卡因30 mL加右美托咪定1 μg/kg)。测量锁骨上阻滞特征及术中血流动力学变化。结果:两组患者人口学因素差异无统计学意义。患者平均年龄43.09±10.92岁,以男性居多。利多卡因-右美托咪定组感觉-运动阻滞的平均起效时间比另一组快,感觉-运动阻滞和镇痛持续时间比另一组长。这些差异具有统计学意义。两组间及两组间9次评估时间血流动力学参数差异均有统计学意义。结论:锁骨上阻滞法在利多卡因基础上加入右美托咪定可加速阻滞起效,延长阻滞时间及术后镇痛时间,且无明显副作用。
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