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Introduction: Brachial plexus block is sole anesthesia for upper limb surgeries. Several techniques have been used to prolong the duration of regional anesthesia. The aim of the study: To compare the effectiveness of Clonidine as adjuvants to Ropivacaine in supraclavicular Brachial plexus block for prolonging the duration of motor blockade and prolonging the duration of analgesia. Materials and methods: 60 Patients of ASA grade I and II undergoing upper limb surgeries were randomly assigned into two groups R and RC. Surgery was done under the subclavian perivascular approach of supraclavicular brachial plexus block. The patients in group R received 25 ml at 0.75% Ropivacaine with 1 ml Normal saline. In a group RC received 25 ml at 0.75% Ropivacaine and 1 ml of (150 micrograms) clonidine. Parameters observed were a time of onset at the sensory block and motor block, duration of motor blockade, and sensory blockade, duration of postoperative analgesia, sedation score and side effects. Results: Addition of clonidine to Ropivacaine shows early onset of motor blockade compared to Ropivacaine alone. Addition of clonidine to local anesthetic solution significantly prolongs the duration of postoperative analgesia by 276 minutes compared to Ropivacaine alone. Addition of clonidine to Ropivacaine increased the duration of motor blockade by 132 minutes compared to Ropivacaine alone. S. Arul Rajan, N. Sathyan, T. Murugan. Comparison of clonidine adjuvants to ropivacaine in subclavian perivascular approach of supra clavicular brachial plexus block. IAIM, 2018; 5(5): 33-37. Page 34 Conclusion: The addition of clonidine to the local anesthetic in supraclavicular brachial plexus produces the early onset of sensory and motor blockade and prolongs the duration of both sensory and motor blockade and postoperative analgesia, when compared to Ropivacaine alone.
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JUSTIFICATIVA E OBJETIVOS: As dores neuropáticas podem apresentar sinais inequívocos, mas, podem ser de difícil diagnóstico e o tratamento é difícil. O objetivo deste estudo foi relatar o caso de um paciente com dor crônica pós-traumática, com baixa adesão ao tratamento farmacológico e que foi tratado com bloqueios periféricos e adjuvantes. RELATO DO CASO: Paciente do gênero masculino, 42 anos, sofreu acidente automobilístico com trauma no quadril e na região lombar direita. Foi submetido à laparotomia exploradora com nefrectomia direita, osteossíntese de fêmur direito e de semilunar direito. Evoluiu com dor na região lombar direita que não melhorava com as medicações prescritas e com baixa adesão ao esquema terapêutico proposto, devido a sua difícil situação socioeconômica. Optou-se pelos bloqueios de nervos periféricos, em cinco sessões, realizados em regime ambulatorial. CONCLUSÃO: O tratamento com os bloqueios de nervos periféricos na região lombar foi eficaz e reduziu as sintomatologias da dor neuropática em até 60%, permanecendo com intensidade entre 3 e 4 pela escala analógica visual e ausência de dor ao toque da cicatriz.
BACKGROUND AND OBJECTIVES: Neuropathic pain may have earmarks, but may be difficult to diagnose and treat. This study aimed at reporting a case of post-traumatic chronic pain, with poor adherence to pharmacological treatment, which was treated with peripheral blocks and adjuvants. CASE REPORT: Male patient, 42 years old, who suffered a car accident with hip and right lumbar region trauma. Patient was submitted to laparotomy with right nephrectomy, right femur and right lunate osteosynthesis. Patient evolved with right lumbar region pain not improving with prescribed drugs and with poor adherence to proposed therapeutic approach due to his difficult socio-economic status. We decided for peripheral nerve blocks in five sessions, in outpatient regimen. CONCLUSION: Treatment with peripheral nerve blocks in the lumbar region was effective and has decreased neuropathic pain symptoms in up to 60%, remaining with intensity between 3 and 4 by the visual analog scale and with no pain when the scar was touched.