Comparison of the effects between clonidine and epinephrine added with bupivacine in brachial plexus block

Abstract

Background: Demonstration of alpha adrenoreceptors in the peripheral nervous system has made to study the effects of various alpha adrenergic drugs with local anesthetics in peripheral nerve blocks. This study is designed to compare the efficacy of clonidine and epinephrine when added to bupivacaine in brachial plexus block. Methods: Forty ASA 1 and 2 patients undergoing upper limb surgeries under supraclavicular brachial plexus block were divided into two groups in a randomized double blinded fashion. Group BA received 5 mcg/ml of adrenaline and group BC recieved mcg/ kg of clonidine along with 30 ml of 0.375% bupivacaine. Onset of sensory and motor blockade, duration of analgesia, hemodynamic stability were studied in both the groups. Results: Onset of sensory and motor blockade were 6.25+1.33 minutes and 3.80+0.834 minutes respectively in group BA and 5.85+1.26 minutes and 3.55+1.05 minutes respectively in group BC which were not statistically significant between the two groups. Duration of analgesia was 7.12+0.63 hours in group BA and 12.69+1.28 hours in group BC which was statistically significant (p value 0.001). There were no significant difference in the hemodynamic parameters between the two groups. Conclusion: Addition of clonidine to bupivacaine in supraclavicular brachial plexus block provides a significant advantage over epinephrine to bupivacaine in terms of postoperative analgesia without any significant side effects.