Comparative study to assess the quality of analgesia of bupivacaine and bupivacaine with dexmedetomidine in ultrasound-guided pectoral nerve block type I and II in breast surgeries

Background and Aims: Dexmedetomidine has been demonstrated to be safe and efficacious in prolonging the duration of peripheral nerve blocks. This study was designed to compare the duration, quality of postoperative analgesia, hemodynamic stability, and patient's satisfaction with addition of dexmedetomidine to bupivacaine versus plain bupivacaine in pectoral nerve block (Pecs) type I and II in breast surgeries. Material and Methods: This prospective randomized double-blind study was carried out in 60 American Society of Anesthesiologists grade I-III female patients, aged 18-70 years randomly allocated into two equal groups. Group A received 10 ml 0.25% bupivacaine for pecs I block and 20 ml 0.25% bupivacaine for pecs II block. Group B received 10 ml 0.25% bupivacaine with dexmedetomidine for pecs I block and 20 ml 0.25% bupivacaine with dexmedetomidine in pecs II block, keeping a total dose of dexmedetomidine of 1 mu g/kg body weight and the volume constant in both the groups. Results: Numerical rating scores at rest and on abduction of arm were significantly lower in Group B. There was a 40% increase in duration of complete analgesia in dexmedetomidine group (1024.0 +/- 124.9 min) compared to plain bupivacaine (726.4 +/- 155.3 min; P < 0.001). Total consumption of injection diclofenac sodium in 24 h was 23% less in Group B (77.5 +/- 13.6 mg) compared to Group A (100.0 +/- 35.9 mg, P = 0.003). Patient satisfaction score was significantly better in dexmedetomidine group. No adverse effects were noted in either group. Conclusion: Dexmedetomidine as an adjunct to bupivacaine helps prolong the duration and improves the quality of postoperative analgesia in pecs I and II block without serious side effects.