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Clonidine as an Adjuvant to Ropivacaine in Brachial Plexus Block

Ajai Vikram Singh, Associate Professor, Department of Anaesthesiology & Critical Care, Veer Chandra Singh Garhwali Government Institute Of Medical Science and Research (VCSGGMSRI), Srinagar, Garhwal, Uttarakhand 246174, India. , Ajai Vikram Singh

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Indian Journal of Anesthesia and Analgesia 5(8):p 1407-1411, August 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5818.25

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Abstract

Regional blocks are gaining popularity to perform surgery by blocking an isolated part of the body. Trauma is one of the consequences of this fast moving world. To deal with the surgeries related to upper limb, brachial plexus block is the most popular and effective technique with less side effects and bypasses the exposure of general anaesthesia and its related consequences and side effects. Many drugs are used as adjuvants to local anaesthetic agents to increase its efficacy, for early onset of block and to prolong the duration of block. Bupivacaine has been the most popular and frequently used local anaesthetic agent in various regional blocks but ropivacaine has also been successfully used since this drug has come in existence. In compare to bupivacaine, this drug has less cardiotoxic effects, less arrhythmogenic and less toxic to the central nervous system and has intrinsic vasoconstrictor property. Clonidine is one of the most attractive adjuvant used in regional blocks. It has analgesic and sedative effects and also reduces the anaesthetic requirements, enhances the efficacy and duration of block without any respiratory depression. In this study clonidine has been used as adjuvant to ropivacaine to analyze its effectiveness in brachial plexus block for upper limb surgeries. This study was done on 100 patients of either sex of ASA grade I & II undergoing for upper limb surgeries. It was observed that the degree of sedation was more in the clonidine group in the post-operative period. It was concluded that the addition of 150µgm of clonidine to 20 ml (0.75%) Ropivacaine for brachial plexus block prolongs the duration of motor block, sensory block and post-operative analgesia with adequate and acceptable sedation with minimum side effects.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5818.25

Keywords

Brachial Plexus Block; Supraclavicular Approach; Ropivacaine; Clonidine; Upper Limb Surgery.

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