BACKGROUND AND AIMS Effective postoperative analgesia is essential in upper limb surgeries. Ultrasound-guided supraclavicular brachial plexus block with ropivacaine provides reliable anesthesia and analgesia. Adjuvants such as buprenorphine and dexmedetomidine may prolong block duration and improve analgesic quality. This study aimed to compare the effects of buprenorphine and dexmedetomidine as adjuvants to 0.5% ropivacaine in supraclavicular brachial plexus block. METHODS A prospective, randomized comparative study was conducted on patients undergoing elective upper limb surgeries. Participants were allocated into two groups: Group RB received 0.5% ropivacaine with buprenorphine, and Group RD received 0.5% ropivacaine with dexmedetomidine. The primary outcomes were duration of analgesia, motor block, and sensory block. Secondary outcomes included onset times of sensory and motor block and incidence of adverse effects. Statistical analysis was performed using Student’s t-test and chi-square test, with p < 0.05 considered significant. RESULTS Group RD (dexmedetomidine) demonstrated faster onset of sensory and motor block and significantly prolonged block duration compared to Group RB. Group RB (buprenorphine) provided longer postoperative analgesia but with delayed onset. Side effects were minimal in both groups; Group RD showed occasional bradycardia and hypotension, while Group RB reported mild nausea and sedation. CONCLUSION Both buprenorphine and dexmedetomidine are effective adjuvants to ropivacaine in supraclavicular brachial plexus block. Dexmedetomidine offers superior block quality, whereas buprenorphine ensures extended postoperative analgesia. The choice of adjuvant may be individualized based on clinical priorities.

Buprenorphine, Dexmedetomidine, Ropivacaine, Supraclavicular Block, Regional Anesthesia