Comparative Study of Clonidine and Dexmedetomidine as an Adjuvant with Ropivacaine in Supraclavicular Brachial Plexus Block for Upper Limb Surgery

Abstract

Background: Among alpha 2 adrenergic agonists the role of Clonidine as an adjuvant to local anaesthetics to prolong duration of block is extensively studied but effect of Dexmedetomidine as an adjuvant to local anaesthetics in brachial plexus block is not much investigated. Aim: To compare effects of Clonidine and Dexmedetomidine with inj. Ropivacaine 0.5% in brachial plexus block with regard to block characteristics, post operative analgesia, hemodynamic stability and complications. Materials and Methods: 50 patients of ASA gr I and II undergoing upper extremity surgeries were selected and randomized to receive Clonidine(group RC) or Dexmedetomidine(group RD) with inj. Ropivacaine 0.5% 30 ml in supraclavicular brachial plexus block .Onset and duration of sensory and motor blockade, duration of post operative analgesia, hemodynamic parameters and adverse effects were compared. Results: Significant difference was observed in relation to duration of sensory block 346.8(±74.54) minutes in group RC and 540 (±56.12) min in group RD, duration of motor block 386.4(±67.82) min. and 586.8 (±55.51) min. respectively. Duration of post operative analgesia 372(±70.86) min in group RC and 559 (±55.40) min in group RD. No significant difference was observed in onset of sensory block which is 11.92(±2.55) min in group RC and 11.36(±2.14) min in group RD and onset of motor block which is 18.56(±2.12) min in group RC and 17.28(±2.70) min in group RD. Conclusion: The duration of sensory motor blockade and post operative analgesia was significantly prolonged by Dexmedetomidine with inj Ropivacaine in brachial plexus block without significant hemodynamic alterations. Key words: brachial plexus block, adjuvant, alpha-2 agonists, Clonidine, Dexmedetomidine