A Comparative Study of Clonidine and Dexmedetomidine with 0.5% Levobupivacaine in ultrasound-guided Axillary Brachial Plexus Block for Upper Limb Surgeries

Abstract

Background: Clonidine and Dexmedetomidine as an additive to Levobupivacaine in ultrasound-guided axillary brachial plexus block are not studied well. Hence, this study was designed to compare the efficacy of the Clonidine and Dexmedetomidine, used as an adjunct to Levobupivacaine in ultrasound-guided axillary brachial plexus block in upper limb elective surgery.Materials and Methods: Eighty patients of the American Society of Anesthesiologists Grade I/II undergoing upper limb elective surgery were divided into two equal age/gender-matched groups. Group-LD received ultrasound-guided axillary brachial plexus block using injection 0.5% Levobupivacaine 20 ml+dexmedetomidine (1 μg/Kg), and group LC received ultrasound-guided axillary brachial plexus block using injection 0.5% Levobupivacaine 20 ml + Clonidine (1.5 μg/Kg). The onset and duration of sensory and motor block, hemodynamics, and side effects were recorded. Results: The time for onset of sensory block and motor block in group LD was significantly faster than group LC (4.53±1.07 and 7.88±1.29 min vs. 5.90±0.81 and 8.85±1.81min, p<0.0001). The duration of motor block in group LD was significantly longer than group LC (Sensory and motor block: 662.50 ± 50.95 and 625.50 ± 51.95min, vs 567.75 ± 62.33 and 560.62 ± 67.19 min. p< 0.0001). The sedation score was highly significant at 30 min (p<0.0001) and was significant at 60 min (p<0.05), postoperatively. Conclusion: The addition of Dexmedetomidine (1μg/Kg) as an adjuvant to Levobupivacaine (0.5%) for upper limb surgeries by axillary brachial plexus block had provided the rapid onset of sensory block and motor block and enhanced duration of sensory and motor block with arousable sedation without any adverse effects compared to clonidine (1.5μg/Kg).