To Compare The Efficacy of Adding Clonidine Versus Adding Dexmedetomidine as an Adjunct to 0.25% Bupivacaine in Supraclavicular Brachial Plexus Block

Background: Brachial plexus blockade is a technique used for providing anaesthesia and post-operative analgesia for upper limb surgeries. Among the various approaches, supraclavicular approach is considered safest and most effective. Addition of adjuvants, not only prolongs the analgesic effect but also improves the quality of anaesthesia. Aim And Objectives –The study was undertaken to compare between Clonidine and Dexmedetomidine as adjuvants to 0.25% Bupivacaine in Supraclavicular Brachial Plexus block. Methods: The study was conducted in Gandhi Hospital, Secunderabad after obtaining approval from institutional ethical committee and written informed consent from each patient. Sixty patients aged 18-50 years undergoing upper limb surgeries were included in the study. Patients were randomly divided into two groups of 30 patients each. Group C (Clonidine) – received conventional supraclavicular brachial plexus block with 40 ml of 0.25% Bupivacaine and 0.5 μg/kg of Clonidine. Group D (Dexmedetomidine) – received conventional supraclavicular brachial plexus block with 40ml of 0.25% Bupivacaine and 0.5 μg/kg of Dexmedetomidine. The onset of sensory and motor blockade were noted. Intra-op haemodynamics, post-op pain and side effects were assessed at regular intervals. Results: The duration of analgesia is prolonged with Dexmedetomidine as compared to Clonidine with no significant difference either in onset of sensory and motor blockade or in hemodynamic variables. The only side-effect observed was hypotension in Clonidine group. Conclusion: We conclude that Dexmedetomidine has prolonged duration of analgesia with no side effects as compared to Clonidine.

A Comparative Study of Dexmedetomidine Infusion Vs Clonidine Infusion in Maintaining Intra Operative Haemodynamic Stability and Post Op Analgesia Requirment in Laparoscopic Cholecystectomy

Background: Laparoscopic surgery has become the choice for many procedures owing to it’s minimally invasive technique. This not only reduces the post-operative stress, but also improves the overall outcome. However, it is associated with its own complications. Various drugs have been used to counter the haemodynamic fluctuations caused by laparoscopic surgery. α2 agonists have shown good results when used intraoperatively. Aim and Objectives –1 )To compare between inj.Clonidine and inj.Dexmedotamine in attenuation of stress response and haemodynamic stability intra operatively in laparoscopic surgeries. 2) To compare between the analgesia requirement between inj.Clonidine and inj.Dexmedotamine during post-operative period in laparoscopic cholecystectomy surgery. Methods: After obtaining approval from institutional ethical committee and written informed consent from each patient. Sixty patients aged 20-50 years undergoing laparoscopic cholecystectomy were included in the study. Patients were randomly divided into two groups of 30 patients each. Group C (Clonidine) received inj. clonidine 150 μg and group D received inj.dexmedetomidine 150 μg iv in 100ml NS 30 minutes before induction of anaesthesia. Intra-op haemodynamics, post-op pain and side effects were assessed at regular intervals. Results: Dexmedetomidine being a α2 receptor agonist decreases or inhibits the release of the catecholamines and vasopressin. Dexmedetomidine by its sedative, anxiolytic, and analgesic properties, provides a good haemodynamic control and decreased analgesic requirement postoperatively when compared with Clonidine. Conclusion: We conclude that Dexmedetomidine provides a good haemodynamic control and good analgesia when compared to Clonidine in laproscopic cholecystectomy procedures with good monitoring.