Tramadol sparing effect of dexmedetomidine as an adjuvant with lignocaine in preoperative stellate ganglion block for postoperative pain relief following upper limb surgeries

Recent literature has established the role of stellate ganglion block (SGB) for management of acute postoperative pain. The effects of dexmedetomidine as an adjuvant to lignocaine in a preoperative SGB for postoperative pain relief have not been evaluated so far. The following randomised, double-blinded, control trail included 54 patients scheduled for upper limb orthopaedic surgery under general anaesthesia. Preoperative ultrasound-guided (USG) SGB was performed in all patients. Group I (n？=？18) received 3.5？mL of a solution (3？mL 2% lignocaine？+？0.5？μg/kg dexmedetomidine for SGB) and 15？mL of intravenous (IV) normal saline (NS). Group II (n？=？18) received 3.5？mL of a solution (3？mL 2% lignocaine？+？0.5？mL NS for SGB) and 15？mL of IV NS. Group III (n？=？18) received 3.5？mL of a solution (3？mL 2% lignocaine？+？0.5？mL of NS for SGB) and 0.5？μg/kg dexmedetomidine in 15？mL of IV NS. Postoperatively tramadol consumption and Visual Analogue Scale (VAS) score were recorded up to 48？hours. The cumulative tramadol consumption at the end of 48？hours (p？=？0.01) was significantly reduced in the group I as compared to group II. In group I, postoperative VAS at rest was significantly reduced up to 12？hours postoperatively as compared to group II (p？=？0.05). The cumulative tramadol consumption was not reduced significantly in group III compared to group II (p？=？0.51). Dexmedetomidine as an adjuvant to SGB along with lignocaine produced a significant tramadol sparing effect and superior analgesia as compared to IV dexmedetomidine and control group.