Background: Ultrasound-guided supraclavicular brachial plexus block provides effective anesthesia for upper limb surgeries. The use of adjuvants with local anesthetics aims to enhance block characteristics and prolong postoperative analgesia. Comparative data on dexmedetomidine and fentanyl as adjuvants to levobupivacaine remain limited.
Methods: This prospective, randomized, single-blinded controlled study included 60 adult patients (ASA I–II) scheduled for elective upper limb surgeries. Patients were allocated into three equal groups (n = 20 each). Group L received 0.5% levobupivacaine alone, Group LD received levobupivacaine with dexmedetomidine (1 μg/kg), and Group LF received levobupivacaine with fentanyl (1 μg/kg). Onset and duration of sensory and motor blockade, duration of postoperative analgesia, sedation scores, hemodynamic parameters, adverse events, and surgeon satisfaction were assessed.
Results: Baseline demographic variables were comparable among groups (mean age: 34.1 ± 12.6, 33.5 ± 11.8, and 32.7 ± 13.2 years in Groups L, LD, and LF respectively; p = 0.92). The onset of sensory block was significantly faster in Group LD (11.2 ± 1.7 min) compared to Group LF (14.9 ± 2.1 min) and Group L (18.6 ± 2.8 min) (p < 0.001). Duration of sensory block was longest in Group LD (705 ± 65 min), followed by Group LF (535 ± 60 min) and Group L (420 ± 50 min) (p < 0.001). Duration of postoperative analgesia was significantly prolonged in Group LD (725 ± 70 min) compared to Group LF (565 ± 63 min) and Group L (430 ± 52 min). Bradycardia occurred more frequently in Group LD (20%) but was transient and manageable. Surgeon satisfaction rated as good to excellent was highest in Group LD (95%).
Conclusion: Dexmedetomidine is a superior adjuvant to fentanyl when combined with levobupivacaine for supraclavicular brachial plexus block, offering improved block characteristics and prolonged analgesia with an acceptable safety profile.
Keywords: N\A.
How to cite this article: Ram G, Rajan US, Kumar P, Vijayakumar L, Dexmedetomidine and Fentanyl as an Adjunct to Levobupivacaine 0.5% in Supraclavicular Nerve Block: A Randomized Controlled Trial. Int J Drug Deliv Technol. 2026;16(5s): 247-253; DOI: 10.25258/ijddt.16.5s.30
Source of support: Nil
Conflict of interest: None