COMPARISON OF DEXMEDETOMIDINE AND CLONIDINE AS AN ADJUVANT TO BUPIVACAINE IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK

Deba Gopal Pathak, Manmayoori Phatowali

Abstract


Background and aims:-Adjuvants are often used with local anaesthetics in supraclavicular brachial plexus block(SBPB) for its synergistic effect by prolonging the duration of sensory and motor block. Alpha 2 agonists, clonidine and dexmedetomidine are combined with local anaesthetics to extend the duration of regional anaesthesia.The purpose of this study was to compare the effects of clonidine and dexmedetomidine as an adjuvant to bupivacaine(0.25%) in Supraclavicular brachial plexus block(SBPB) with respect to the hemodynamic variations;onset,duration of sensory and motor block along with duration of analgesia.

Methodology:-A randomized double blind prospective study involving 75 patients aged between 18 and 60yrs of ASA status I and II undergoing upper limb surgeries under SBPB was carried out at SMCH.The patients were randomly divided into three groups:Group B–received 35 ml of 0.25% Bupivacaine with 2ml of 0.9% normal saline,GroupC–received 35 ml of 0.25 % Bupivacaine with Clonidine 1μg/kg mixed with 0.9% normal saline to make total volume of 2ml and GroupD–received 35ml of Bupivacaine 0.25% with Dexmedetomidine 1μg/kg mixed with 0.9% normal saline to make a total volume of 2ml.Heart rate,systolic and diastolic blood pressure; onset and duration of sensory blocks, motor blocks and duration of analgesia;sedation and adverse effects,if any,were assessed.

Results:The groups were comparable with respect to age,sex,weight,ASA status and surgical characteristics.The mean onset of sensory and motor blockade and mean duration of sensory and motor blockade were faster and prolonged in Group D in comparison to Group C and Group B which were statistically highly significant(p<0.001).Hypotension,bradycardia, sedation and decreased respiratory rate were seen in few patients in Dexmedetomidine group.

Conclusion: We conclude that dexmedetomidine can be a better alternative to clonidine when administered with Bupivacaine as an adjuvant for SBPB for upper limb surgeries.


Keywords


Clonidine,dexmedetomidine,supraclavicular brachial plexus block

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References


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