Efficacy Of Clonidine Research Articles

A historical perspective on clonidine as an alpha-2A receptor agonist in the treatment of addictive behaviors: Focus on opioid dependence.

Clonidine operates through agonism at the alpha-2A receptor, a specific subtype of the alpha-2-adrenergic receptor located predominantly in the prefrontal cortex. By inhibiting the release of norepinephrine, which is responsible for withdrawal symptoms, clonidine effectively addresses withdrawal-related conditions such as anxiety, hypertension, and tachycardia. The groundbreaking work by Gold et al. demonstrated clonidine's ability to counteract the effects of locus coeruleus stimulation, reshaping the understanding of opioid withdrawal within the field. In the 1980s, the efficacy of clonidine in facilitating the transition to long-acting injectable naltrexone was confirmed for individuals motivated to overcome opioid use disorders (OUDs), including physicians and executives. Despite challenges with compliance, naltrexone offers sustained blockade of opioid receptors, reducing the risk of overdose, intoxication, and relapse in motivated patients in recovery. The development of clonidine and naltrexone as treatment modalities for OUDs, and potentially other addictions, including behavioral ones, underscores the potential for translating neurobiological advancements from preclinical models (bench) to clinical practice (bedside), ushering in innovative approaches to addiction treatment.

Use of clonidine in the treatment of Irukandji syndrome: A 4-year retrospective cohort study on safety, efficacy and clinical utility.

Irukandji syndrome (IS) is an extremely painful condition that causes a significant catecholamine surge and sympathetic autonomic response related to the envenomation from certain types of jellyfish. Current management involves intravenous fluids, magnesium sulphate and large doses of opioids for symptom control. Clonidine, a centrally acting alpha-2 agonist, is often used as an analgesic adjunct to reduce opioid requirements in acute pain. The present study explores the safety and efficacy of clonidine in reducing opioid requirements in IS. All patients diagnosed with IS at Cairns Hospital between 1 March 2016 and 30 April 2020, and participants from the Magnesium in Irukandji Study Trial, were included in this retrospective study (n= 114). Cases were separated into two groups depending on whether or not they received clonidine, and subsequently analysed according to pre- and post-intervention opioid requirements, clonidine dose administered and adverse effects. Notably, 39 patients with IS received ≥1 mcg/kg clonidine and the remaining 75 did not. There was no difference in oral morphine equivalent daily dose (oMEDD) between groups before clonidine administration; however, there was a significant reduction in oMEDD required after patients received clonidine (26.1 mg; 95% CI 4.6-47.7) compared with those who did not (66.6 mg; 95% CI 56.9-86.1) (F= 8.722, df= 1 × 224, P= 0.003). One episode of hypotension occurred following the intervention. Patients with IS who received clonidine required significantly lower opioid requirements than those who did not receive clonidine. Clonidine was safe to administer and should be considered early when treating IS. The optimal clonidine dose remains unclear and requires prospective studies to validate our findings.

Efficacy of Clonidine as an Adjuvant to Ropivacaine in Transversus Abdominis Plane Block in Adult Renal Transplant Recipients: A Double-blinded Randomized Controlled Trial.

Transversus abdominis plane (TAP) block has been used to provide analgesia in renal transplant surgery with varying results. This study was designed to assess if the addition of clonidine in TAP block would decrease 24-h postoperative morphine consumption in adult renal transplant recipients. Forty adult patients undergoing renal transplantation under general anesthesia in a tertiary care hospital were randomized into either group RC (TAP block with 20 mL of 0.5% ropivacaine plus 2 μg.kg-1 clonidine) or group R (TAP block with 20 mL 0.5% ropivacaine) after induction of anesthesia. Postoperative analgesia was provided using patient-controlled morphine. The primary outcome was 24-h patient-controlled morphine consumption. The secondary outcomes were a) intraoperative hemodynamics, b) fentanyl and ephedrine requirement, c) postoperative pain using the Visual Analog Scale at 0, 2, 6, 12 and 24 hours, d) time to first postoperative analgesia, e) postoperative hemodynamics, and f) side effects. There was no significant difference in postoperative morphine consumption between the groups (25 mg in group RC vs. 28.5 mg in group R) (median interquartile range) (P = 0.439). Postoperative pain scores were comparable between the groups. Intraoperatively, fewer patients required rescue fentanyl in group RC (7 patients) as compared to group R (17 patients) (P = 0.003). Significantly more patients in group RC required ephedrine boluses as compared to group R (9 patients in group RC vs. 2 in group R, P = 0.014). The addition of 2 μg.kg-1 clonidine to ropivacaine in TAP block did not reduce 24-h postoperative morphine consumption after renal transplantation. It reduced the need for intraoperative analgesics but increased the need for intraoperative ephedrine administration.

Comparison of efficacy of clonidine and tramadol for the control of shivering under spinal anaesthesia in Telangana Population

Comparison of efficacy of clonidine and tramadol for the control of shivering under spinal anaesthesia in Telangana Population

Effectiveness of Oral Clonidine & Oral Gabapentin in Attenuation of Haemodynamic Stress Response to Laparoscopic Cholecystectomy

Background: In laparoscopic surgery, Carbondioxide (CO2) is routinely used to create pneumoperitoneum.Elevated intra-abdominal pressure, due to pneumoperitoneum, and Carbondioxide (CO2) insufflationhave adverse effects on the cardiovascular system. Plasma level of catecholamines and vasopressin areincreased immediately after pneumoperitoneum. Increased catecholamine level activates the renin–angiotensin–aldosterone system, leading to characteristic hemodynamic alterations such as decreasedcardiac output, elevated arterial pressure and increased systemic/pulmonary vascular resistance. Variousdrugs have been used to attenuate these hemodynamic responses. Objectives: Purpose of this study was to evaluate the efficacy of oral Clonidine and oral Gabapentinpremedication in attenuation of haemodynamic stress responses to laparoscopic cholecystectomy. Setting & study design: This Placebo control study was conducted in Department of Anaesthesiologyand ICU, Dhaka Medical College Hospital from 1st March 2015 to 31st August 2015. Total 60 patients withASA grade I, II and planned for elective laparoscopic cholecystectomy were selected. Exclusion criteriawere patients with history of hypersensitivity to Clonidine, Gabapentin, and patients with chronic pain,history of cardiovascular, psychiatric disease, use of psychotropic drugs, pregnancy other comorbidcondition- CKD, COPD, IHD etc. Study subjects were allocated in to groups as placebo or control group(or Group P), gabapentin (300 mg) or Group G and clonidine (100 ìg) or Group C. Tested drugs were given75 to 90 minutes before surgery as oral premedication. All groups were compared for sedation, anxietylevel along with changes of haemodynamic status. Result: Majority of patients (40%) belongs to age 41 to 50 yrs. Out of 60 cases 55% were male and 45%were female. Male – female ratio was 1.22:1. A clear increase in sedation and a moderate decrease inanxiety were observed in both premedicated groups as compared with control groups. Preoperativeanxiolysis and sedation was higher in oral clonidine group as compared with Gabapentin group. Comparedwith group P, gabapentin & clonidine group showed statistically significant decrease in heart rate beforeinduction (98, 80, 74 beat/min respectively). The heart rate increased significantly immediately afterintubation in control group P, whereas no such changes were observed in group G and in group C (132,125, 112 beat/min respectively). After laparoscopy, the attenuation of mean arterial blood pressure inpremedicated group was statistically significant as to control group (Group P) and remained stabilizedduring intraoperative period. Study showed that premedication (Group C and G) patients werecomparatively well oriented and were able to obey commands than control (Group P) in the postoperativecare unit. Postoperative analgesic need was much less with gabapentin (Group G) and clonidine group(Group C) as compared with control (Group P). Conclusion: The gabapentin and clonidine are effective oral premedicant drugs with safe and multimodaldrug profile as they cause sedation, anxiolysis, and analgesia, with successful attenuation of thehemodynamic response of laparoscopy. Efficacy of Clonidine is superior to other also proven. JBSA 2020; 33(2): 48-54

Comparative In Vitro Study of Various α2-Adrenoreceptor Agonist Drugs for Ticagrelor Reversal

Ticagrelor, an antiplatelet adenosine diphosphate (ADP)-P2Y12 receptor antagonist, increases the risk of bleeding. Its management is challenging because platelet transfusion is ineffective and no specific antidote is currently available. Epinephrine, a vasopressor catecholamine prescribed during shock, restores platelet functions inhibited by ticagrelor through stimulation of α2A-adrenoreceptors. It subsequently inhibits cyclic adenosine monophosphate (cAMP) pathway and PI3K signaling. However, since epinephrine may expose a patient to deleterious hemodynamic effects, we hypothesized that other α2-adrenoreceptor agonist drugs used in clinical practice with fewer side effects could reverse the antiplatelet effects of ticagrelor. We compared in vitro the efficacy of clonidine, dexmedetomidine, brimonidine, and norepinephrine with epinephrine to restore ADP- and PAR-1-AP-induced washed platelet aggregation inhibited by ticagrelor, as well as resulting platelet cAMP levels. In ticagrelor-free samples, none of the α2-adrenoreceptor agonists induced aggregation by itself but all of them potentiated ADP-induced aggregation. Compared with epinephrine, norepinephrine, and brimonidine partially restored ADP- and fully restored PAR-1-AP-induced aggregation inhibited by ticagrelor while clonidine and dexmedetomidine were ineffective. Indeed, this lack of effect resulted from a lower decrease in cAMP concentration elicited by these partial α2-adrenoreceptor agonists, clonidine, and dexmedetomidine, compared with full α2-agonists. Our results support the development of specific full and systemic α2-adrenoreceptor agonists for ticagrelor reversal.

A COMPARATIVE STUDY OF CLONIDINE VERSUS NALBUPHINE AS INTRATHECAL ADJUVANTS TO 0.5% HYPERBARIC BUPIVACAINE DURING LOWER ABDOMINAL SURGERIES – A RANDOMIZED DOUBLE BLIND INTERVENTIONAL STUDY.

Background: Regional anesthesia techniques for gynecological procedures are on increasing trends due to their advantage of postoperative analgesia owing to intrathecal adjuvants. The present study was aimed to comparatively evaluate the clinical efficacy of clonidine with nalbuphine when co-administered intrathecally with 0.5% hyperbaric bupivacaine for Lower abdominal surgeries in Gynecology.
 Methods: With institutional ethics committee clearance No. 193MC/EC/2018, randomized, double blind study was conducted. After obtaining informed written consent total of 84 patients scheduled for lower abdominal surgeries were randomly allocated into two groups:
 Group A (n=42) - Inj. 3.5 ml Bupivacaine 0.5% + 0.2 ml Clonidine(30µg) intrathecally. 
 Group B (n=42) - Inj.3.5 ml Bupivacaine 0.5%+0.2 ml Nalbuphine(2mg) intrathecally.
 The characteristics of sensory and motor block, hemodynamic data, side effects were recorded.
 Results: The onset of sensory block was earlier in Group B than Group A (3.08±0.52 min vs 4.00±0.54 min, p<0.001 ). The onset of motor block was also earlier in Group B than Group A (7.78±0.80 min vs 8.80±0.95min, p<0.001). The time to first rescue analgesia in patients receiving intrathecal clonidine was significantly delayed than patients receiving intrathecal nalbuphine (284.95 ± 12.93 min vs 211.52 ± 15.92 min, p<0.001). Introperative hemodynamic changes were comparable and none of the patient suffered from respiratory depression except very little cases of shivering which are not significant.
 Conclusions: Intrathecal clonidine as adjuvant to bupivacaine provided was clinically more effective than nalbuphine for prolonging the duration of analgesia for gynecological procedures.
 Keywords: Bupivacaine, Clonidine, Lower abdominal surgeries in gynecology, Nalbuphine, Subarachnoid block.

Safety and efficacy of clonidine on postoperative vomiting and pain in pediatric ophthalmic surgery: A systematic review and meta-analysis.

Postoperative vomiting and pain are common, unpleasant phenomena in pediatric patients undergoing ophthalmic surgery. Clonidine has antiemetic and analgesic properties and thus may be used as premedication to reduce postoperative vomiting and pain. To assess whether clonidine premedication may safely decrease postoperative vomiting and postoperative pain in pediatric patients who received an ophthalmic surgery. We systematically searched PubMed, EMBASE, Cochrane Library, and Scopus databases from their inception to September 2018. Randomized clinical trials comparing clonidine premedication with a placebo or an active comparator that investigated postoperative vomiting or postoperative pain in pediatric patients undergoing ophthalmic surgery were included. The primary outcome was postoperative vomiting. The secondary outcome was postoperative pain. We also evaluated the safety of clonidine premedication by tracking hemodynamic instability associated with its use. Ten studies with 979 patients were eligible for inclusion. Clonidine achieved a significantly lower incidence of postoperative vomiting within 6hours postoperatively, 6-24hours postoperatively, and at the end of the study (risk difference: -0.15; 95% confidence interval: -0.32 to -0.05; risk difference: -0.15; 95% confidence interval: -0.29 to 0.01; and risk difference: -0.23; 95% confidence interval: -0.34 to -0.12, respectively) than placebo. For the subgroup of patients who received strabismus surgery, clonidine produced a lower incidence of postoperative vomiting than placebo (risk difference: -0.19; 95% confidence interval: -0.29 to -0.05). Compared to benzodiazepine, clonidine achieved a lower incidence of postoperative vomiting at the end of the study (risk difference: -0.19; 95% confidence interval: -0.31 to -0.07); the effect was only observed in patients receiving clonidine 4μg/kg. Furthermore, children receiving clonidine had lower postoperative pain scores, lower analgesic requirements, and more of them were pain-free compared to those who received a placebo. No patient using clonidine had any major hemodynamic instability. Compared to placebo or benzodiazepine, clonidine premedication was effective in reducing postoperative vomiting in pediatric patients undergoing ophthalmic surgery. Clonidine premedication also provided more reduction in postoperative pain when compared to placebo. The use of clonidine premedication was not associated with adverse hemodynamic events.

A COMPARATIVE STUDY OF ORAL CLONIDINE VERSUS ORAL PREGABALIN ON HEMODYNAMIC RESPONSES TO LARYNGOSCOPY AND ENDOTRACHEAL INTUBATION UNDER GENERAL ANAESTESIA

Background: Laryngoscopy and endotracheal intubation are potent stimuli that can induce increased sympathetic activity leading to tachycardia, hypertension and dysrrhythmias. Various drugs and methods have been tried to obtund this response. To obtain ideal drugs, studies still continue. We compared the efficacy of clonidine and pregabalin to attenuate the pressor response during laryngoscopy and intubation.
 Method: Total 80 patients of ASA grade I scheduled for elective surgery under general anaesthesia, were randomized into two groups. Group A received oral clonidine 300 mcg 2 hrs prior to surgery, group B received oral pregabalin 75mg 2 hrs prior to surgery. Heart rate and blood pressure (SBP, DBP &MAP) were recorded at baseline, before induction, before intubation, during laryngoscopy, 0, 1, 3, 5, and 10 minutes after intubation.
 Results: When compared to clonidine and pregabalin, there was a significant increase in HR and MAP in pregabalin after laryngoscopy and tracheal intubation. Clonidine was better than pregabalin in suppressing the pressor response.
 Conclusion: Clonidine appears to be better than Pregabalin for control of haemodynamic response to laryngoscopy and intubation besides providing sedation.
 Keywords: Clonidine, Pregabalin, hemodynamic changes and endotracheal intubation.

Efficacy of Clonidine as an Additive on the Duration of Action of Brachial Plexus Block Performed Under Ultrasound and Nerve Locator Guidance: A Prospective Randomized Study.

Background:Clonidine, an alpha2 agonist, when added to local anesthetics in different regional and neuraxial blocks reduces the onset time, improves the efficacy, and increases the duration of postoperative analgesia.Aims:This study evaluated the effect of bupivacaine clonidine combination in ultrasound and nerve locator-guided supraclavicular brachial plexus block for upper limb surgeries.Settings and Design:This was a prospective, randomized, controlled, double-blind study carried out in a tertiary care center in South India on 50 patients with American Society of Anesthesiologists (ASA) physical status classes I and II undergoing elective upper limb surgery under supraclavicular brachial plexus block.Materials and Methods:Eligible participants were randomized equally to either Group B who received 20 ml of bupivacaine and 7 mL of 2% lignocaine or Group C who received 20 ml of bupivacaine, 7 ml of 2% lignocaine, and 100 μg of clonidine.Statistical Analysis:Continuous outcome variables were tested for statistical significance using Student's t-test, and Mann–Whitney U-test was used for outcomes that were nonnormally distributed. Categorical variables were compared using Fisher's exact test. P <0.05 was considered as statistically significant.Results:The onset of sensory and motor blockade was significantly faster (P < 0.05) in Group C compared to Group B. The duration of sensory and motor block and the duration of analgesia were significantly longer in Group C (P < 0.001). The sedation in Group C patients was significantly more (P < 0.05) when compared to Group B, but none of the sedation scores exceeded 3 on the Ramsay sedation score. Hemodynamic parameters did not differ between groups (P > 0.05).Conclusion:The inclusion of 100 μg of clonidine with bupivacaine in ultrasound-guided supraclavicular brachial plexus blocks prolongs both sensory and motor blockade. It also provides significant postoperative analgesia and mild sedation which is beneficial in the immediate stressful postoperative period.

Efficacy of Clonidine as an Adjuvant to Ropivacaine in Ultrasound guided Supraclavicular Brachial Plexus Block: A Prospective Study

Efficacy of Clonidine as an Adjuvant to Ropivacaine in Ultrasound guided Supraclavicular Brachial Plexus Block: A Prospective Study

The Efficacy of Clonidine Added to Bupivacaine as Compared to Bupivacaine Alone Used in Supraclavicular Brachial Plexus Block

The Efficacy of Clonidine Added to Bupivacaine as Compared to Bupivacaine Alone Used in Supraclavicular Brachial Plexus Block

Blood pressure lowering efficacy of clonidine for primary hypertension

Blood pressure lowering efficacy of clonidine for primary hypertension

A comparative study of Fentanyl and Clonidine as additives to plain Bupivacaine in caudal anaesthesia in children

Introduction: The efficacy of clonidine or fentanyl as additives to alter the neuroendocrine stress response and emergence agitation in caudal anaesthesia in children is still not clear. Objectives: To compare the efficacy and safety of Fentanyl and Clonidine as additives to plain bupivacaine in caudal anaesthesia in children. Materials & Methods: A prospective, open labeled randomized controlled trial was conducted in Meenakshi Mission Hospital and Research Centre, Madurai, between August 2008 to June 2010. Children undergoing various elective infra-umbilical surgical procedures were included. Children were randomly assigned to either 0.5% Bupivacaine(B), Fentanyl plus 0.5% Bupivacaine (BF) or Clonidine Plus 0.5% Bupivacaine(BC) groups. Results: A total of 90 children, with 30 subjects in each of the three intervention groups were included. Time taken for spontaneous movement was significantly higher (151.8±11.7) in BC group, as compared the other two groups. The duration of postoperative analgesia was lowest in Bupivacaine (146±91.2) alone group, followed by BF (293.5±154.5) and BC group (510±359.9). Sedation time also has shown a similar trend. The mean pain scores from 2 hours to 24 hours were highest in bupivacaine group, followed by BF and BC group. The differences in the sedation scores across the three study groups from 45minutes to 24-hour post-operative period were statistically significant. Conclusions: Addition of clonidine 1µg/kg to 0.5% bupivacaine prolonged the duration of postoperative analgesia after a single shot caudal injection without any significant side effects when compared to bupivacaine 0.5% alone or its combination with fentanyl 1µg/kg.

Efficacy of Clonidine with Dexmedetomidine Added as Adjuvant to Bupivacaine (0.25%) for Brachial Plexus Block By Supraclavicular Approach: A Randomized Control Trial

Efficacy of Clonidine with Dexmedetomidine Added as Adjuvant to Bupivacaine (0.25%) for Brachial Plexus Block By Supraclavicular Approach: A Randomized Control Trial

A Study on Efficacy of Clonidine and Dexmedetomidineas Adjuvants with 0.5% Levobupivacaine in Ultrasound Guided Axillary Brachial Plexus Block for Upper Limb Orthopedic Surgeries

A Study on Efficacy of Clonidine and Dexmedetomidineas Adjuvants with 0.5% Levobupivacaine in Ultrasound Guided Axillary Brachial Plexus Block for Upper Limb Orthopedic Surgeries

Comparative study of clonidine versus esmolol on hemodynamic responses during laparoscopic cholecystectomy

BackgroundLaparoscopic surgical procedures have various benefits to the patient in terms of decreased tissue damage, early ambulation, decreased hospital stay and reduced analgesic needs. Pneumoperitoneum with carbon dioxide (CO2) leads to stimulation of the sympathetic nervous system which can be a risk factor in patients with cardiovascular diseases. Moreover, reverse Trendelenburg position affects homeostasis in laparoscopic surgeries. In this study, we compared the efficacy of clonidine (which is α2 adrenergic agonist) versus esmolol (which is ultra short acting cardio-selective β1-receptor antagonist) on the hemodynamic response during laparoscopic cholecystectomy.Materials and methodsA total of 60 patients scheduled to undergo laparoscopic cholecystectomy were randomly assigned into two groups: Group C: received 2 μg/kg of clonidine diluted in 20 ml normal saline, given with slow intravenous infusion over 10 min just before induction of GA and Group E: received 1.5 mg/kg of esmolol as a loading dose over a period of 5 min just before induction of GA followed by 10 μg/kg/min as a maintenance dose throughout the procedure. No hypnotic medication was given on the evening before surgery. Systolic, diastolic, mean arterial blood pressures and heart rate were recorded at (1) baseline, (2) three minutes after endotracheal intubation, (3) before pneumoperitoneum, (4) fifteen minutes after pneumoperitoneum, (5) thirty minutes after pneumoperitoneum, (6) five minutes after release of CO2 and (7) five minutes after extubation. Degree of sedation according to Ramsay sedation score was assessed 15 min after reaching PACU.ResultsBoth groups were similar with respect to demographic data. Clonidine group showed more stability in hemodynamic responses than esmolol group in all hemodynamic variables but with more postoperative sedation.ConclusionThis study concluded that clonidine and esmolol provide hemodynamic stability in laparoscopic cholecystectomy but clonidine provides more stability with postoperative sedation.

Comparison of caudal epidural clonidine with fentanyl as an adjuvant to ropivacaine 0.25% for postoperative analgesia in children undergoing various infraumbilical surgeries: A prospective randomized study

Background Caudal epidural block is commonly used as a safe, reliable, easy-to-administer technique for abdominal and lower limb surgeries in pediatric patients and allows rapid recovery from anesthesia with effective postoperative analgesia. The aim of our study was to compare the efficacy of clonidine versus fentanyl when used as an additive to ropivacaine during single-shot caudal epidural analgesia in pediatric patients for postoperative pain relief. Patients and methods This randomized prospective double-blind study was conducted on 60 children of American Society of Anesthesiologists grades I and II aged 1–7 years scheduled for various infraumbilical surgical procedures who were randomly allocated into two groups to receive either ropivacaine (0.25%, 1 ml/kg) and clonidine (2 μg/kg) (group RC) or ropivacaine (0.25%, 1 ml/kg) and fentanyl (1 μg/kg) (group RF). Caudal epidural block was performed after induction of general anesthesia. Postoperatively, patients were observed for duration of analgesia, sedation score, recovery time, hemodynamics, and side effects or complications. Results Both groups were similar with respect to patient’s demographic profile, baseline hemodynamic parameters, and duration of surgery. The analgesic properties and hemodynamics were also comparable in both groups (P>0.05). The mean recovery time and sedation score were significantly lower in group RC as compared with group RF (P Conclusion From our study we concluded that both clonidine (2 μg/kg) and fentanyl (1 μg/kg) can be used as an adjuvant to single-shot caudal epidural anesthesia using 0.25% ropivacaine for effective postoperative analgesia in children. Because of its more favorable side-effect profile, with less respiratory depression, nausea, vomiting, and more patient comfort, clonidine is a better choice for use as an adjuvant to caudal epidural anesthesia in children.

A COMPARATIVE STUDY BETWEEN DEXMEDETOMIDINE AND CLONIDINE USED AS ADJUNCTS TO BUPIVACAINE FOR POST-OPERATIVE ANALGESIA BY CAUDAL BLOCK IN PAEDIATRIC PATIENTS

Caudal anaesthesia/analgesia is simple to perform, reliable and safe. Various adjuvants are tried with local anaesthetic to prolong duration of post-operative a nalgesia in caudal block in paediatric patients wit h variable results. This prospective study was designed to ass ess and compare the efficacy of clonidine and dexme detomidine used as an adjuvants to bupivacaine for caudal anal gesia in paediatric patients. A 100 patients of ASA grade I or II ,age group of 6 months to 6 years undergoing infra- umblical surgeries were included in one of the foll owing two groups. Group D received 1 µg/kg Dexmedetomidine while group C received 1 µ g/kg Clonidine both with Bupivacaine plain 0.25% 1 ml/kg. Post-operative analgesia was assessed using CRIES scale. The mean duration of post-operative analgesia in group D was 14.16 ± 1 .65 hours and in group C it was 11.24 ± 2.48. The p rolongation of post-operative analgesia was significantly longe r in group D compared to group C and the requirement of rescue analgesic doses in the first 24 post-operative hour s was less in group D compared to group C. The inci dence of adverse effects were statistically insignificant be tween the two groups.The addition of both dexmedetomidine and clonidine with bupivacaine administered caudally s ignificantly increase the duration of post-operativ e analgesia.

Efficacy of clonidine as an adjuvant to ropivacaine in supraclavicular brachial plexus block: A prospective study.

Background and Aims:Bupivacaine has been the most frequently used local anaesthetic in brachial plexus block, but ropivacaine has also been successfully tried in the recent past. It is less cardiotoxic, less arrhythmogenic, less toxic to the central nervous system than bupivacaine, and it has intrinsic vasoconstrictor property. The effects of clonidine have been studied in peripheral nerve blockade. The purpose of this study was to evaluate the effects of clonidine on nerve blockade during brachial plexus block with ropivacaine using peripheral nerve stimulator.Methods:Sixty patients were randomly divided into two groups, Group A and B. Group A received 30 ml of 0.5% of ropivacaine with 0.5 ml normal saline while Group B received same amount of ropivacaine with 0.5 ml (equivalent to 75 μg) of clonidine for supraclavicular brachial plexus block. The groups were compared regarding quality of sensory and motor blockade, duration of post-operative analgesia and intra and post-operative complications.Results:There was a significant increase in duration of motor and sensory block and analgesia in Group B as compared to Group A patients (P < 0.0001). There was no significant difference in onset time in either group (P = 0.304). No significant side effects were noted.Conclusion:The addition of 75 μg of clonidine to ropivacaine for brachial plexus block prolongs motor and sensory block and analgesia without significant side effects.