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Comparision of Bupivacaine with and without Clonidine as for Supraclavicular Approach to Brachial Plexus Block

B. Sai Naveena Lakshmi, , P.T. Rajya Lakshmi Devi1 , B. Sai Naveena Lakshmi2

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Indian Journal of Anesthesia and Analgesia 6(1):p 303-310, Jan-Feb 2019. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6119.43

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P.T. Rajya Lakshmi Devi, B. Sai Naveena Lakshmi. Comparision of Bupivacaine with and without Clonidine as for Supraclavicular Approach to Brachial Plexus Block. Indian J Anesth Analg. 2019;6(1):303-310.

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Abstract

Introduction: The role of peripheral nerve blockade was expanded for management of post operative pain and chronic pain. Tramadol and fentanyl had been successfully used as adjuvant to local anaesthetic in brachial plexus block. Clonidine seems to provide analgesic benefit without major adverse effects. Aim: To evaluate whether additional anesthetic and analgesic effects could be derived from administration of Clonidine, an α 2- adrenergic agonist, into brachial plexus sheath. To compare the effects of Inj. Bupivacaine and Injection Bupivacaine with Clonidine as adjunct, used for Supraclavicular approach to brachial plexus block. Materials and methods: The study was a prospective, randomized, double-blind study. Sixty patients aged between 18 and 60 years of physical status ASA 1 and 2 undergoing upper limb surgeries lasting more than 30 minutes were included in the study. Patients were randomized into 2 groups of 30 each. All patients received brachial plexus block with 40 ml of 0.25% Bupivacaine. In addition, Bupivacaine+clonidine group received Clonidine at the dose of 2 µg/kg. Results: Onset of sensory blockade (time between injection and total loss of sensation to temperature) was faster in group C (22.33±4.1 min) compared to group B (27.17±3.64 min), which was statistically significant. Duration of sensory blockade (the time between injection and complete recovery from sensory disturbance) was also longer in Bupivacaine +clonidine group (524.00±83.91 minutes) compared to Bupivacaine group (339.00±57.44 minutes) and this difference was both clinically and statistically significant (p=0.001). Onset of motor blockade was faster in Bupivacaine +clonidine group (26.83±3.34 minutes) compared to Bupivacaine group (29.50±2.74 minutes).The duration of motor blockade was longer in Bupivacaine +clonidine group (524.00±83.91 minutes) compared to Bupivacaine group (339.00±57.44 min) and this difference was both clinically and statistically significant (p=0.001). Also, the time for demand of analgesics was significantly prolonged in group C (527.67±81.79 minutes) compared to group B (340.00±58.07 minutes) this difference was also statistically significant (p= <0.001). Conclusion: Addition of Clonidine to Bupivacaine solution for brachial plexus block can modify the action of local anaesthetic solution by its local action. There were no clinically significant side effects noticed. Hence, Clonidine can form an useful adjuvant for Bupivacaine when used for brachial plexus block.

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P.T. Rajya Lakshmi Devi, B. Sai Naveena Lakshmi. Comparision of Bupivacaine with and without Clonidine as for Supraclavicular Approach to Brachial Plexus Block. Indian J Anesth Analg. 2019;6(1):303-310.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6119.43

Keywords

Bupivacaine; Clonidine; Brachial Plexus Block.

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