A Comparative Study of Supraclavicular Brachial Plexus Block with Clonidine as Adjuvant in Two Different Doses in Upper Limb Surgery
Journal Title: Journal of Clinical and Diagnostic Research - Year 2018, Vol 12, Issue 11
Abstract
ABSTRACT Introduction: Supraclavicular route of brachial plexus block is considered as ‘The Spinal of Arm’, in which local anaesthetic agent is delivered at a point where the three trunks are compactly arranged and carry entire sensory, motor and sympathetic innervations of the upper extremity. Aim: To compare the efficacy of two moderate doses of clonidine as an adjuvant to lignocaine and bupivacaine in combination in supraclavicular brachial plexus block by using USG guided method. Materials and Methods: After approval by the research Ethics Committee and written informed consent, the randomised controlled study was carried out in 90 ASA I and II patients, who were posted for unilateral upper limb surgery. Supraclavicular brachial plexus block was performed using an ultrasound-guided technique with a total volume of 30.6 mL of drugs. Group N received 15 mL of 2% lignocaine with adrenaline (1 in 200000) and 15 mL of 0.5% bupivacaine with 0.6 mL of normal. Group C1 received 45 μg of clonidine and Group C2 received 90 μg of clonidine along with the local anaesthetics. The time taken for onset and the duration of sensory and motor blocks were noted until 24 hours postoperatively. Vitals were noted before, during and after anaesthesia. The time required for rescue analgesia was noted along with VAS scores and sedation scores. The results were tabulated and correlations were obtained using ANOVA and Student’s t-test. Results: The mean duration (in minutes) of onset of motor block was 14.6±3.024 in Group N, 7.567±1.0726 in Group C1, 6.033±1.756 in Group C2. The mean duration (in hours) of motor block was 3.8±0.6967 in Group N, 5.65±1.1533 in Group C1, 8.05±0.9035 in Group C2. The mean onset of time (in minutes) of sensory block is 14.9±3.1442 in Group N, 6.8±1.0635 in Group C1 and 5.4±2.4403 in Group C2. The mean duration (in hours) of sensory block was 4.233±0.6915 in Group N, 5.833±1.0367 in Group C1 and 8.417±0.8914 in Group C2. The differences were highly statistically significant (p<0.001). Rescue analgesia was required much earlier in Group N (4.43±0.774 hours) than in Group C1 (6.87±0.9 hours) and C2 (10.43±2.339 hours). Conclusion: Ninety microgram clonidine is an attractive alternative as an adjuvant in the ultrasound-guided supraclavicular block for upper limb surgical procedures especially in those that need quite long time with minimal side effects and excellent quality of postoperative analgesia.
Authors and Affiliations
Shreya Das Adhikari, Manoj Kumar Panwar, Shweta Mahajan
Keywords
Related Articles
- EP ID EP526242
- DOI 10.7860/JCDR/2018/33877.12198
- Views 60
- Downloads 0
Prediction of Difficult Laparoscopic Cholecystectomy during the First Conversation with the Patient
ABSTRACT Introduction: Laparoscopic Cholecystectomy (LC) is the gold standard now for symptomatic cholelithiasis. Any unexpected turn of events intra-operatively has significant implications which get multiplied many fo...
Interruption Regions in the White Line: A Novel Panoramic Finding in the Risk Assessment of Mandibular Canal Exposure by Third Molar
ABSTRACT Introduction: Panoramic markers are the indicators which can be demonstrated in panoramic radiograph to aid in dental diagnosis. Several panoramic markers were developed as diagnostic approach to predict Mandibu...
Immunohistochemical Study of MUC1, MUC2 and MUC5AC Expression in Primary Breast Carcinoma
Introduction: Breast Cancer (BC) is the second most common cancer among women in India and accounts for 7% of global burden of BC and one-fifth of all Cancers (CA) among women in India. Aim: This study was conducted for...
Role of Echocardiography in Prenatal Screening of Congenital Heart Diseases and its Correlation with Postnatal Outcome
Introduction: Congenital Heart Defects (CHDs) are one of the most common forms of congenital anomalies. Fetal echocardiography performed during second trimester aims at early diagnosis of congenital heart disease which i...
Effectiveness of Two Topical Anaesthetic Agents used along with Audio Visual Aids in Paediatric Dental Patients
Introduction: Topical anaesthetic agents enable pain free intraoral procedures, symptomatic pain relief for toothache, superficial mucosal lesions and pain related to post extraction time. Most common anxiety provoking a...