Comparative evaluation of effects of adding Dexmedetomidine, Dexamethasone and Na Bicarbonate to Ropivacaine in ultrasound-guided supraclavicular block on the quality of the block in orthopedic surgery

Determining the effect of adding dexmedetomidine, dexamethasone, and sodium bicarbonate to ropivacaine in the ultrasound-guided supraclavicular block on the quality of the block in orthopedic surgery

A clinical trial with the control group, parallel groups, three-way blind, randomized, phase 3 on 120 patients. Random Allocation software was used for randomization.

Patients are placed in a semi-sitting position (30 degrees), then the supraclavicular block is performed by an ultrasound guide and half of the drug is injected in the pocket corner and the other half in the middle of the brachial plexus. All injections are performed using a spinal needle No. 22 connected to the Extension tube. The drug used for the block is prepared and coded by the project partner as follows and is provided to the executor. The codes are provided to the executor after sampling and statistical analysis.

Inclusion criteria: Age 18 years and older Weight (Lean body mass) between 50 to 90 kg ASA 1 and 2 were Introduced for upper limb surgery (distal to the lower third of the arm) Exclusion criteria: Local infection at the site of the block Existence of coagulation disorder or taking anticoagulants Hypersensitivity to dexmedetomidine, dexamethasone, and ropivacaine

In all patients, the supraclavicular block is performed under ultrasound guide by injection of 30 ml of ropivacaine 5 mg/ml by the performer. In the first to third groups, the following items are added in a volume of one ml, respectively: 30 micrograms of dexmedetomidine, 0.6 ml of 7.5% bicarbonate solution, 4 mg (1 ml) of dexamethasone In the control group, 1 ml of normal saline is added to the drug.

Interval of drug injection to the onset of sensory and motor block, duration of sensory and motor block

Patients are placed in one of four experimental groups using a table of random numbers. The default movement in the table from right to left and from bottom to top is considered and the numbers 0 to 29 in group 1 and the numbers 30 to 59 in group 2 and the numbers 60 to 89 in group 3 and the numbers 90 to 119 They are in group 4. The starting point of the movement in the table is determined randomly by the first client by placing a finger with his eyes closed on the table.

The project partner prepared the drug used to perform supraclavicular block by adding additive (dexmedetomidine, sodium bicarbonate, dexamethasone, or normal saline) to ropivacaine in similar syringes and in the same final volume and after coding (1 to 4) It is provided to the executor, the executor (drug injector and data collector) and the patient are not aware of the type of drug added to the injectable ropivacaine and the codes will be opened after sampling and statistical analysis are completed.