comparative study between ropivacaine 30 ml [0.75%] and ropivacaine 30 ml [0.75%] with clonidine 150 microg as an adjuvant in brachial plexus block through supraclavicular approach

ABSTRACT

Ropivacaine is a novel alternative to bupivacaine with the less cardiovascular system and central nervous system toxicity. Clonidine, an alpha 2 agonist, may have benefited patients when it is injected at peripheral nerve sites with local anesthetic ropivacaine. Clonidine is second only to epinephrine as a useful adjuvant for brachial plexus blockade. A clinical study was carried out to compare the anesthetic effects of ropivacaine alone and clonidine as an adjuvant to ropivacaine in brachial plexus block for upper limb surgeries. A comparative, double-blind, prospective, randomized, clinical study was carried out on 60 patients of either sex of American Society of Anesthesiologist physical status I and II, with age group 25-65 years undergoing various orthopedic surgeries of upper limb under supraclavicular brachial plexus block. Patients were randomly allocated to either of the two groups of 30 each. Group-R Injection ropivacaine 30 ml [0.75%] with 1 ml normal saline. Group-ropivacaine clonidine [RC] linjection ropivacaine 30 ml [0.75%] with injection clonidine 1 ml [150 microg]. Heart rate, mean arterial pressure, onset and duration of motor and sensory blockade were observed during preoperative, intraoperative and postoperative period. At the end of the study, the data were analyzed using Chi-square test for qualitative data and Student t-test. P < 0.05 was considered significant and P < 0.01 was considered as highly significant. Demographic and hemodynamic data were comparable. Onset of sensory and motor block was significantly earlier in Group-R. Duration of analgesia and motor blockade was prolonged in the RC group. Both groups were observed for the side-effects, which were not significant. Addition of clonidine 150 microm to ropivacaine 0.75% 30 ml delays the onset of sensory and motor blockade while prolongs the postoperative motor blockade and analgesia significantly without producing any clinical significant side-effects in brachial plexus block through supraclavicular approach: