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A Comparative Study between Bupivacaine and Clonidine Combination versus Bupivacaine (Plain) for Brachial Plexus blocks using Supraclavicular Approach

Senthil M , Naveena P1 , Senthil M2 , Sabapathy VA3 , Brindha R4 , Harish P5 , Shankar R6

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Indian Journal of Anesthesia and Analgesia 6(4):p 1171-1776, July-August 2019. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6419.17

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Naveena P, Senthil M, Sabapathy VA et al. A Comparative Study between Bupivacaine and Clonidine Combination versus Bupivacaine (Plain) for Brachial Plexus blocks using Supraclavicular Approach. Indian J Anesth Analg. 2019;6(4):1171-1176.

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Received : N/A         Accepted : N/A          Published : N/A

Abstract

Background: Brachial plexus block achieves ideal operating conditions by producing complete muscle relaxation, maintaining stable intra-operative hemodynamics and associated sympathetic block. Usage of adjuvant drugs along with local anesthetic, to lower the dose of each agent and enhance analgesic efficacy and thereby reducing the incidence of adverse events is a routine practice in regional anesthesia. Aim: To assess the anesthetic and analgesic effect of adding clonidine with bupivacaine as a regional anesthetic agent for brachial plexus block during upper limb surgeries. Methodology: A prospective longitudinal study was conducted for a period of one year from the anesthesiology department of Vinayaka Missions Medical College Hospital Salem. A total of 60 patients were included for the study and it was divided into two groups. Group A patients received 25 ml of 0.5% bupivacaine and group B patients received 25 ml of 0.5% bupivacaine along with 0.2 ml (30 mcg) clonidine. Onsite time and the duration of sensory and motor block was recorded along with the duration of analgesia and the maximum number of doses of analgesics required were also noted. Vitals were recorded at intervals of 5 min for first 30 min, then after every 10 min till end of surgery, and then hourly after surgery. Results: The onset of sensory and motor block was found to be much quicker and prolonged for a longer duration among the patients who received bupivacaine along with clonidine and the difference in time duration was found to be statistically significant. Similarly, the post-operative analgesia effect was found to be longer (487.9 mins)among the group received bupivacaine with clonidine with a less number of additional requirement of analgesia dose (1.1 dose) whereas the analgesia effect among the group received bupivacaine alone was 303.6 mins with mean additional dose of analgesia of 2.4 and the difference was found to be statistically significant. Vital parameters were normal and were almost similar among both the groups. Conclusion: Thus, our study had demonstrated that addition of clonidine as an adjuvant drug along with bupivacaine as a regional anesthetic agent in supraclavicular brachial plexus block had significatly prolonged the duration of analgesia and improved the quality of anesthesia.

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Naveena P, Senthil M, Sabapathy VA et al. A Comparative Study between Bupivacaine and Clonidine Combination versus Bupivacaine (Plain) for Brachial Plexus blocks using Supraclavicular Approach. Indian J Anesth Analg. 2019;6(4):1171-1176.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6419.17

Keywords

Brachial plexus blockBupivacaineClonidineAnalgesia.

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