A COMPARATIVE STUDY OF CLONIDINE AND DEXMEDETOMIDINE AS AN ADJUVANT IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 14
Abstract
BACKGROUND Supraclavicular block provides anaesthesia for upper extremity in the most consistent andf efficient manner of any brachial plexus technique. Adjuvants when added to local anaesthetics enhance the onset and prolongs the duration of block. α2 agonists produce analgesia, sympatholysis and sedation, hence considered as effective adjuvant. The aim of this study is to compare the efficacy and safety of two α2 agonists, i.e. clonidine and dexmedetomidine as an adjuvant for brachial plexus block. MATERIALS AND METHODS It was a prospective, randomised and double-blind study. Sixty patients of ASA grades I and II undergoing forearm surgeries were randomly divided into two groups of 30 patients each. Group C patients received Inj. Bupivacaine (0.5%) 2 mg/kg + Inj. Lignocaine (2%) 5 mg/kg with adrenaline + Inj. Clonidine 1 μg/kg. Group D patients received Inj. Bupivacaine (0.5%) 2 mg/kg + Inj. Lignocaine (2%) 5 mg/kg with adrenaline + Inj. Dexmedetomidine 1 μg/kg. Parameters noted were onset, completion and duration of sensory and motor block, duration of analgesia, Ramsay sedation score, vital parameters and complications if any. Results were analysed by student’s unpaired ‘t’ test and chi-square test. RESULTS Onset and time for complete sensory and motor block was significantly faster in the dexmedetomidine group when compared to the clonidine group. The total duration of sensory and motor block and duration of analgesia was also significantly longer in Group D. Both the groups had stable haemodynamics. No complications or side effects were observed in both the groups. CONCLUSION Dexmedetomidine can be used as an adjuvant, alternative to clonidine in supraclavicular brachial plexus block with prolongation of both sensory and motor block, and without any haemodynamic instability and systemic side effects.
Authors and Affiliations
Pramod Kumar Palai, Dulal Kishun Soren, Prativa Panda, Sraban Kumar Dash
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