A Comparative Study of Evaluating Effects of Dexmedetomidine and Buprenorphine as an Adjuvant to Bupivacaine in Scalp Block for Supratentorial Craniotomy Surgeries in a Tertiary Care Hospital

Abstract

Background: Regional anaesthesia techniques have been shown to be effective in reducing intraoperative aesthetic requirement, provide intraoperative hemodynamic stability and postoperative analgesia requirement too. Scalp block when used in patients with craniotomy provides effective analgesia for short duration; however, addition of dexmedetomidine may prolong duration of analgesia and provide intraoperative hemodynamic stability. Similar effects may be observed with buprenorphine. Hence, we aimed to evaluate effect of scalp block with addition of dexmedetomidine and buprenorphine to bupivacaine on intraoperative hemodynamic parameters and postoperative analgesia in patients undergoing supratentorial craniotomy.

Methods: We enrolled 60 patients undergoing elective supratentorial craniotomy and divided into two groups; group B received 19ml of bupivacaine 0.25% with 2mcg/kg of buprenorphine making volume of 20 ml and group D received 19ml of bupivacaine 0.25% with 1 mcg/kg of dexmedetomidine with total volume of 20 ml. Patients hemodynamic parameters were recorded intraoperatively and VAS score, rescue analgesia requirement was noted postoperatively.

Results: We found that patients were more stable hemodynamically in intraoperative period in dexmedetomidine group compared to buprenorphine group. Duration of analgesia was significantly prolonged in dexmedetomidine group. Sedation score and postoperative analgesia requirement was more in buprenorphine group.

Conclusion: Our study found that addition of dexmedetomidine and buprenorphine prolonged duration of analgesia postoperatively and provided intraoperative hemodynamic stability. However, these effects were better with dexmedetomidine group and were without much sedation and other postoperative complications compared to buprenorphine group.