Brachial plexus block at various levels has been in use for upper extremity surgeries since its description by Kulenkampff in 1928(1). Supraclavicular approach to brachial plexus block has remained the most popular because of its ubiquitous application for upper extremity surgeries, predictability and complete anesthesia of upper limb(2). After a brief period of disfavor due to risk of pneumothorax, application of nerve stimulation and recent introduction of ultrasonography for localization of brachial plexus has rekindled anesthesiologist’s interest in supraclavicular block(3).

Although bupivacaine remains commonly used local anesthetic for performance of nerve blocks due to its long duration of action and good motor blockade, concerns about toxicity at higher doses remain. Levobupivacaine, a less cardiotoxic s- isomer of bupivacaine is proved to be similar to bupivacaine if not for pharmaco-economic considerations hence proposed as a safer alternative to the former for performance of nerve blocks(4).

Even with increasing use of perineural catheters for pain relief, many anesthesiologists still continue to use single-shot techniques for nerve blocks. This has led to the practice of using additives to local anesthetics with intent to improve the quality and duration of block. Among others, selective α₂ agonist dexmedetomidine has been studied for its ability to affect the axillary brachial plexus block characteristics. Intravenous administration of dexmedetomidine along with spinal anesthesia has been found to prolong the duration of block(5–7). Few studies have evaluated the effect of intravenous dexmedetomidine on brachial plexus block(8). Albeit the availability of studies on the effect of dexmedetomidine on axillary brachial plexus block performed by nerve stimulator guidance with Levobupivacaine (9), no study has evaluated the effect of dexmedetomidine on ultrasound guided supraclavicular brachial plexus block with Levobupivacaine.