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The efficacy and safety of clonidine and dexmedetomidine as an adjuvant in supraclavicular brachial plexus block for elective upper limb surgery

Yogesh Tilkar, Sangeeta Bansal Agarwal, Rahul Gupta, Sanjeevani Karmalkar, Prabha Khatri, Neetu Gupta.




Abstract

Background: Adjuvant play very important role in regional anesthesia and search for better adjuvant is still going on.

Objectives: The objectives of this study are to find equipotent doses and to compare the efficacy of two α2 agonists clonidine and dexmedetomidine as an adjuvant in supraclavicular block.

Materials and Methods: A total of 90 patients of the American Society of Anaesthesiologists 1 and 11 of age 20-50 years undergoing elective upper limb surgeries under supraclavicular block divided into three groups: Group N: Received injection bupivacaine 0.5% 15 ml + injection. Lignocaine with adrenaline 2% 15 ml + normal saline 0.5 ml. Group D: 1 μg/kg dexmedetomidine. Group C: 1.5 μg/kg clonidine as studied drug in place of normal saline. Onset, duration of sensory and motor block, duration of analgesia, visual analog scale (VAS) score, hemodynamics, sedation, and other side-effects noted down.

Results: Onset of sensory and motor block in Group D (8.13 ± 2.52 and 12.13 ± 2.90), Group C (7.97 ± 2.58 and 12.47 ± 2.89), and Group N (12.43 ± 2.57 and 17.97 ± 3.06) groups, respectively. Duration of sensory and motor block was 528.2 ± 105.27 and 464.17 ± 93.15 in Group D, 544.97 ± 113.51 and 476.57 ± 105.41 in Group C, and 292 ± 77.4 and 257 ± 75.63 in Group N, respectively. Duration of analgesia was 644.93 ± 118.45 in Group D and 646.93 ± 112.18 in Group C and 352.6 ± 84.39 in Group N. Both studied groups were comparable to each other in above parameters and are significantly better than Group N. VAS score in the post-operative period at 360 min was higher in Group N (5.12 ± 0.68) when compared to Group C (4.5 ± 0.73) and Group D (2.07 ± 0.94), respectively.

Conclusion: Dexmedetomidine and clonidine as an adjuvant to supraclavicular block were found equipotent in the studied doses. However, post-operative VAS was found low in dexmedetomidine group.

Key words: Clonidine; Dexmedetomidine; Supraclavicular Block






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