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Dexmedetomidine is a Better Adjuvant than Clonidine, with Ropivacaine in Supraclavicular Brachial Plexus Block

Priyanka Selvam , Gunaseelan Sivasamy1 , Priyanka Selvam2 , Thirunavukkarasu M3 , Raghuraman MS

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Indian Journal of Anesthesia and Analgesia 6(4):p 1343-1346, July-August 2019. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6419.39

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Gunaseelan Sivasamy, Priyanka Selvam, Thirunavukkarasu M et al. Dexmedetomidine is a Better Adjuvant than Clonidine, with Ropivacaine in Supraclavicular Brachial Plexus Block. Indian J Anesth Analg. 2019;6(4):1343-1346.

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Abstract

Regional anesthesia has some advantages over general anesthesia such as it can be used in outpatient anesthesia, for patients with full stomach, for diabetic patients, associated cardiac, pulmonary, hepatic or renal damage and poly-trauma. Alpha-2 agonists added to local anaesthetic drugs increases the duration of painless period during and after surgery. Here we elicit the clinical Performance of this two drugs dexmedetomidine and clonidine as an additive agent to local anaesthetics like ropivacaine in blocking the brachial plexus by supraclavicular method. The clinical parameters we study here are onset, duration of Duration of blockade (both S and M) and analgesia time and hemodynamic stability. Material and Methods: Prospective study was done on patients undergoing upper arm surgeries under brachial block were split into two equivalent groups. D-group received 0.375% ropivacaine (30 ml) plus one mcg/kg dexmedetomidine, C- group received 0.375% ropivacaine (30 ml) plus one mcg/kg clonidine. Results: Statistical analysis shows significant difference in onset of sensory (S) and motor (M) blockade, highly significance in duration of sensory and motor blockade between D and C groups (p=0.0001). High Statistical significance was seen analgesia duration (p=0.0001) and number of rescue analgesics used (p=0.0001) among D and C groups. Conclusion: Dexmedetomidine has more additive benefits than clonidine when combined with ropivacaine by making the onset of clinical effect earlier, prolonging the blockade extent (both S and M) and painless period during post surgery with fewer requirements of rescue analgesics after arm, forearm and hand surgeries.

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Gunaseelan Sivasamy, Priyanka Selvam, Thirunavukkarasu M et al. Dexmedetomidine is a Better Adjuvant than Clonidine, with Ropivacaine in Supraclavicular Brachial Plexus Block. Indian J Anesth Analg. 2019;6(4):1343-1346.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6419.39

Keywords

Ropivacaine; Clonidine; Dexmedetomidine; Sensory blockade (S); Motor blockade(M); Local anaesthetic.

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