COMPARISON BETWEEN CLONIDINE AND EPINEPHRINE AS ADJUVANT TO BUPIVACAINE IN RESPECT TO ONSET AND POST OPERATIVE DURATION OF ANALGESIA IN SUPRA CLAVICULAR APPROACH BRACHIAL PLEXUS BLOCK IN UPPER LIMB SURGERY.

Dr Biswajit Bej, Dr Sujata Dalai

Abstract


Introduction: Supraclavicular brachial plexus block is a popular and widely employed regional nerve block technique for intra-operative anaesthesia and post-operative analgesia for surgery of upper extremity. Local anaesthetics alone for supraclavicular brachial plexus block provide good operative condition but have shorter duration of postoperative analgesia. Alpha-2 agonists are mixed with local anaesthetic agents to extend the duration of spinal, extradural and peripheral nerve blocks.

Materials and Methods: Seventy patients patients, scheduled  for  elective  upper  limb  surgeries under supraclavicular brachial plexus block were divided into two equal groups in a randomized, double-blinded fashion. Group C received clonidine 150 μg, group E received epinephrine 200
microgram added to 0.5 ml/kg body weight of 0.5% bupivacaine. Onset time and duration of sensory and motor block, duration of analgesia and cardiorespiratory variables were studied in the two  groups.

Results: The onset time, duration of complete sensory and motor block   was statistically highly significant between two groups. Time to rescue analgesic was longer in group C than group E.

Conclusion: Small dose of clonidine produces early sensory and motor onset along with enhancement of the quality of the peripheral nerve block from local anesthetics and limits its two side effects to bradycardia and hypotension.


Keywords


CLONIDINE, EPINEPHRINE, anaesthesia

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References


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