The Effects of Dexmedetomidine Added to Levobupivacaine in Axillary Brachial Plexus Block

Background and Aims: Perineural dexmedetomidine has been used as an adjuvant to various local anesthetics in peripheral nerve blocks. We aimed to assess the anesthetic effects of dexmedetomidine added to levobupivacaine in axillary brachial plexus block for elective forearm and hand surgery.
Methods: Sixty-four patients undergoing elective forearm and hand surgery were enrolled in the study. Patients in the levobupivacaine group (Group L, n=32) received 39 mL of 0.5% levobupivacaine plus 1 mL of normal saline, while patients in the dexmedetomidine group (Group LD, n=32) received 39 mL of 0.5% levobupivacaine plus 50 μg of dexmedetomidine and 0.5 mL of normal saline. The onset times and durations of sensory and motor blocks, duration of analgesia, number of patients requiring rescue analgesics, total analgesic requirements during the first 24 postoperative hours, Ramsay Sedation Scale scores, hemodynamic parameters, and adverse effects were recorded.
Results: The durations of sensory and motor blocks and analgesia were significantly longer in Group LD than in Group L. The onset times of sensory and motor blocks were similar in both groups. Dexmedetomidine significantly decreased heart rate, blood pressure, and analgesic requirements during the first 24 postoperative hours. Modified Ramsay Sedation Scale scores were higher in Group LD than in Group L. No adverse events or neurological sequelae were observed.
Conclusion: Adding dexmedetomidine to levobupivacaine for axillary brachial plexus block in elective forearm and hand surgery prolonged the duration of nerve blockade and reduced postoperative analgesic requirements without causing adverse effects.