Comparative evaluation of 0.75% ropivacaine with clonidine and 0.5% bupivacaine with clonidine in infraclavicular brachial plexus block.

Abstract

Background:Infraclavicular brachial block with coracoids approach has gained popularity because of consistent bony landmarks and less chances of vascular puncture and pneumothorax.Aim:The aim of this study was to evaluate the effect of adding clonidine to bupivacaine or ropivacaine on the onset and duration of sensory and motor block and duration of analgesia in infraclavicular block.Materials and Methods:In a prospective randomized double-blind study, 60 patients of 18–65 years were randomly divided in to two groups of 30 each. Infraclavicular block was performed with 30 ml of 0.75% ropivacaine + 150 μg clonidine in group R and 30 ml of 0.5% bupivacaine + 150 μg clonidine in group B and were compared for onset and duration of sensory and motor block, postoperative analgesia, side-effects and complications.Results:Significant differences were observed in the time for onset of sensory block (5.80 ± 5.12 min in group R and 4.87 ± 1.46 min in group B, P < 0.05); onset of motor block (11.37 ± 2.66 min in group R and 9.60 ± 1.78 min in group B, P < 0.05); duration of sensory and motor block (10.07 ± 0.91 and 9.03 ± 0.89 h in group R and 12.50 ± 1.14 and 10.67 ± 1.18 h in group B respectively, P < 0.01) and duration of analgesia (15.30 ± 1.39 h in group R and 18.07 ± 1.66 h in group B). No significant difference was observed in hemodynamics, sedation, side-effects and complications.Statistical Analysis:Variables were compared using Chi-square test for nonparametric data and Student's t-test for parametric data.Conclusion:Addition of clonidine to bupivacaine lead to early onset and prolonged duration of sensory and motor block with prolonged analgesia as compared to the addition of clonidine to ropivacaine.