Clonidine and dexmedetomidine as adjuvant to ropivacaine for supraclavicular brachial plexus block during upper limb surgery: A comparative study
DOI:
https://doi.org/10.3126/ajms.v13i7.44299Keywords:
Analgesia, Anesthetics, Brachial plexus block, Clonidine, Dexmedetomidine, Local, Peripheral nerves, Ropivacaine, Upper extremityAbstract
Background: Various adjuvants are added to local anesthetics to increase the duration of block during supraclavicular brachial plexus (SCBP) block. Dexmedetomidine, a newer and potent alpha2 receptor agonist, has 10 times higher selectivity than clonidine. Many studies have already evaluated the efficacy of clonidine and dexmedetomidine as perineural adjuvants and have reported wide variations in the prolongation of post-operative analgesia. Some studies have reported the absence of adjuvant’s effect while a few have not focused all the facets of block characteristics.
Aims and Objectives: The aim of the study was to compare the efficacy of clonidine and dexmedetomidine as adjuvant to ropivacaine during SCBP block for the upper limb surgeries, in terms of duration of post-operative analgesia (Primary outcome). The onset and duration of sensory and motor block, and adverse effects, if any, were observed.
Materials and Methods: Ninety patients, aged between 40 and 60 years of either sex, undergoing upper limb surgery, were randomly allocated in to three groups to receive either 30 ml of 0.5% ropivacaine and 2 ml saline (Group R, n=30) or 30 ml 0.5% ropivacaine plus clonidine (1 mcg/kg) plus saline to make a total volume 32 ml (Group C, n=30), or 30 ml 0.5% ropivacaine and dexmedetomidine (1 mcg/kg) plus saline to make a total volume 32 ml (Group D, n=30). The duration of post-operative analgesia, other block characteristics, and adverse events, if any, was assessed.
Results: Mean duration of post-operative analgesia was found to be considerably higher in dexmedetomidine group compared with clonidine group and ropivacaine alone group (664.13 vs. 551.77 vs. 465.47, respectively, P<0.001). The duration of sensory and motor block was considerably longer in dexmedetomidine group compared with clonidine and control group. Adverse events were comparable among the three groups.
Conclusion: Dexmedetomidine appears to be a better alternative to clonidine as adjuvant in terms of prolonged post-operative analgesia and comparable adverse events.
Downloads
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Asian Journal of Medical Sciences
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with this journal agree to the following terms:
- The journal holds copyright and publishes the work under a Creative Commons CC-BY-NC license that permits use, distribution and reprduction in any medium, provided the original work is properly cited and is not used for commercial purposes. The journal should be recognised as the original publisher of this work.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).