Effect of Added Alpha 2 Agonists with Local Anaesthetic in Infraclavicular Brachial Plexus Block: A Comparative Study between Dexmedetomidine and Clonidine

Dexmedetomidine as an Adjuvant in Peripheral Nerve Block

Peripheral nerve block technology is important to balanced anesthesia technology. It can effectively reduce opioid usage. It is the key to enhance clinical rehabilitation as an important part of the multimodal analgesia scheme. The emergence of ultrasound technology has accelerated peripheral nerve block technology development. It can directly observe the nerve shape, surrounding tissue, and diffusion path of drugs. It can also reduce the dosage of local anesthetics by improving positioning accuracy while enhancing the block's efficacy. Dexmedetomidine is a highly selective drug α₂-adrenergic receptor agonist. Dexmedetomidine has the characteristics of sedation, analgesia, anti-anxiety, inhibition of sympathetic activity, mild respiratory inhibition, and stable hemodynamics. Numerous studies have revealed that dexmedetomidine in peripheral nerve blocks can shorten the onset time of anesthesia and prolong the time of sensory and motor nerve blocks. Although dexmedetomidine was approved by the European Drug Administration for sedation and analgesia in 2017, it has not yet been approved by the US Food and Drug Administration (FDA). It is used as a non-label drug as an adjuvant. Therefore, the risk-benefit ratio must be evaluated when using these drugs as adjuvants. This review explains the pharmacology and mechanism of dexmedetomidine, the effect of dexmedetomidine on various peripheral nerve block as an adjuvant, and compare it with other types of adjuvants. We summarized and reviewed the application progress of dexmedetomidine as an adjuvant in nerve block and look forward to its future research direction.

Application Effect of Computer-Assisted Local Anesthesia in Patient Operation

In order to avoid the psychological harm caused by pain to patients, in this study, the application effect of computer-assisted local anesthesia in patient surgery was studied. In this method, 72 patients with hypertension, 35 males and 37 females, aged 53–83 years, with an average age of 70.8 ± 1.3 years, were selected for appointment tooth extraction in the department of stomatology from January to December 2014. All patients were booked for tooth extraction by ECG monitoring. Patients who were contraindicated for tooth extraction, had a history of mental illness, and had used antianxiety drugs and sedatives within 1 week before surgery were excluded. Patients were randomly divided into two groups according to their ID numbers: observation group, 36 cases, and control group. Painless oral local anesthesia injection instrument was used for local anesthesia injection. In the control group, 36 patients were injected with local anesthesia by traditional manual injection. The results showed that 86.11% of patients in the observation group had decreased anxiety scores after anesthesia, while only 13.88% of patients in the control group had decreased anxiety scores. Among patients with decreased anxiety scores, 80.65% in the observation group became nondental anxiety compared with 28.57% in the control group. Computer-assisted oral local anesthesia can effectively control dental anxiety and relieve the pain and discomfort of local anesthesia injection, and improve patient satisfaction, conducive to the smooth nursing work.