{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:24:37Z","timestamp":1787775877629,"version":"build-2784847793"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Suppl 1","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,5]]},"abstract":"\n A\n BSTRACT<\/jats:sc>\n <\/jats:title>\n \n Background:<\/jats:title>\n The supraclavicular brachial plexus block (SCBPB) demonstrates wide surgical use for upper limbs through its application of levobupivacaine as the chosen local anesthetic because it offers lower cardiotoxic effects. Patients benefit from adjuvant medications dexmedetomidine and nalbuphine since these compounds increase blockade sustainability and enhance characteristics of the block.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n The research investigated 60 patients with upper limb surgery that received ultrasound-guided SCBPB. The study design was prospective randomized double-blind. The research participants were divided into two groups of 30 each: Group D used 30 ml of 0.5% levobupivacaine with dexmedetomidine set at 50 \u03bcg, and Group N applied 30 ml of 0.5% levobupivacaine with nalbuphine at 10 mg. The authors analyzed and compared the block onset time along with the duration of sensory and motor block activity and analgesic period as well as hemodynamic changes and adverse effects between both groups.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n The participants in Group D experienced faster sensory block onset times that were statistically lower than those observed in Group N with 7.5 \u00b1 1.2 minutes versus 9.2 \u00b1 1.4 minutes (\n P<\/jats:italic>\n < 0.05). The time for motor block to take effect exhibited the same pattern as sensory block establishment. The subjects in Group D demonstrated longer blocks compared to subjects in Group N regarding sensory preservative time and motor preservative time [(sensory: 720 \u00b1 30 min, motor: 680 \u00b1 25 min) versus (sensory: 580 \u00b1 35 min, motor: 540 \u00b1 30 min)] (\n P<\/jats:italic>\n < 0.05). The subjects in Group D received an extended duration of analgesic effects (850 \u00b1 40 minutes) than those in Group N (660 \u00b1 45 minutes) (\n P<\/jats:italic>\n < 0.05). The subjects in both groups maintained stable hemodynamic conditions yet experienced mild bradycardia in Group D and mild sedation in Group N. The study revealed no severe adverse occurrences between any groups.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Dexmedetomidine along with nalbuphine made levobupivacaine more effective in SCBPB, yet dexmedetomidine created longer-lasting effects on sensory and motor block while providing prolonged analgesic benefits.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jpbs.jpbs_698_25","type":"journal-article","created":{"date-parts":[[2025,5,10]],"date-time":"2025-05-10T04:02:10Z","timestamp":1746849730000},"page":"S890-S893","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["A Comparative Study of the Effect of Dexmedetomidine and Nalbuphine as an Adjuvant to Levobupivacaine in Ultrasound-Guided Supraclavicular Brachial Plexus Block: A Prospective Randomized Double-Blind Study"],"prefix":"10.4103","volume":"17","author":[{"given":"Jyoti","family":"Mala","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Critical Care, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudha","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pankaj","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arvind","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,5,10]]},"reference":[{"key":"R1-20250513","doi-asserted-by":"crossref","first-page":"203","DOI":"10.4314\/ejhs.v24i3.3","article-title":"Dexmedetomidine an adjuvant to levobupivacaine in supraclavicular brachial plexus block: A randomized double-blind prospective study","volume":"24","author":"Biswas","year":"2014","journal-title":"Ethiop J Health Sci"},{"key":"R2-20250513","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1007\/s00540-018-2512-x","article-title":"Nalbuphine as an adjuvant to 0.25% levobupivacaine in ultrasound-guided supraclavicular block provided prolonged sensory block and similar motor block durations (RCT)","volume":"32","author":"Abdelhamid","year":"2018","journal-title":"J Anesth"},{"key":"R3-20250513","doi-asserted-by":"crossref","first-page":"40","DOI":"10.4103\/0259-1162.200225","article-title":"Perineural nalbuphine in ambulatory upper 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meta-analysis","volume":"124","author":"El-Boghdadly","year":"2017","journal-title":"Anesth Analg"},{"key":"R6-20250513","doi-asserted-by":"crossref","first-page":"1463","DOI":"10.2147\/DDDT.S405294","article-title":"Dexmedetomidine as an adjuvant in peripheral nerve block","volume":"17","author":"Chen","year":"2023","journal-title":"Drug Des Devel Ther"},{"key":"R7-20250513","doi-asserted-by":"crossref","DOI":"10.1155\/2022\/8704569","article-title":"Effect of fentanyl as an adjuvant to brachial plexus block for upper extremity surgeries: A systematic review and meta-analysis of RCTs","author":"Song","year":"2022","journal-title":"Pain Res Manag 2022"},{"key":"R8-20250513","doi-asserted-by":"crossref","first-page":"3385","DOI":"10.2147\/DDDT.S432600","article-title":"Analgesic efficacy of nalbuphine as an adjuvant to ropivacaine in erector spinae plane block for percutaneous nephrolithotomy: A randomized, double-blinded, clinical trial","volume":"17","author":"Sun","year":"2023","journal-title":"Drug Des Devel Ther"},{"key":"R9-20250513","first-page":"e930197","article-title":"Different doses of nalbuphine combined with dexmedetomidine in laparoscopic oophorocystectomy","volume":"27","author":"Liu","year":"2021","journal-title":"Med SciMonit"},{"key":"R10-20250513","doi-asserted-by":"crossref","first-page":"981","DOI":"10.4103\/aer.AER_55_17","article-title":"Effect of locally administered dexmedetomidine as adjuvant to levobupivacaine in supraclavicular brachial plexus block: Double-blind controlled study","volume":"11","author":"Bisui","year":"2017","journal-title":"Anesth Essays Res"},{"key":"R11-20250513","doi-asserted-by":"crossref","first-page":"443","DOI":"10.4103\/aer.aer_145_21","article-title":"A comparative study of effect of 0.25% levobupivacaine with dexmedetomidine versus 0.25% levobupivacaine in ultrasound-guided supraclavicular brachial plexus block","volume":"15","author":"Iyer","year":"2021","journal-title":"Anesth Essays Res"},{"key":"R12-20250513","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1097\/WNF.0000000000000410","article-title":"Nalbuphine exhibited a better adjuvant than dexmedetomidine in supraclavicular brachial plexus block in youths","volume":"43","author":"Jiang","year":"2020","journal-title":"Clin Neuropharmacol"},{"key":"R13-20250513","doi-asserted-by":"crossref","first-page":"638","DOI":"10.4103\/aer.aer_54_21","article-title":"Effect of added alpha 2 agonists with local anaesthetic in infraclavicular brachial plexus block: A comparative study between dexmedetomidine and clonidine","volume":"14","author":"Sreeja","year":"2020","journal-title":"Anesth Essays Res"},{"key":"R14-20250513","doi-asserted-by":"crossref","first-page":"e5846","DOI":"10.1097\/MD.0000000000005846","article-title":"Dexmedetomidine as an adjuvant to local anesthetics in brachial plexus blocks: A meta-analysis of 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