Abstract

COMPARISON OF DEXMEDETOMIDINE AND CLONIDINE (?2 AGONIST DRUGS) AS AN ADJUVANT TO LOCAL ANAESTHETICS IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK

Parimal K. Patel* and Bhaarat S. Maheshwari

ABSTRACT

Background and aims: It has been reported that dexmedetomidine when used as an adjuvant in a dose of 1 mcg/kg in adults increase the duration of peripheral nerve blocks and duration of analgesia. Hence, this study was conducted to evaluate the effect of dexmedetomidine in brachial plexus block and to compare it with clonidine. Material and methods: Fifty patients posted for upper limb surgeries were divided randomly into two groups. 30 ml of local anaesthetic solution was prepared using 15 ml of 0.5% Bupivacaine and 15 ml of 2% lignocaine + adrenaline (1:200000). Patients received a supraclavicular brachial plexus block with 30 ml of this solution to which either 1 mcg/kg dexmedetomidine, or 1 mcg/kg clonidine was added. The onset and duration of sensory and motor block and the duration of postoperative analgesia were recorded. Pulse rate, blood pressure, respiratory rate, saturation, and any side effects were monitored. Results were statistically analysed using unpaired student t-test. Results: There was statistically no significant difference in onset of both sensory and motor components of the block. Duration of sensory and motor block was (519.2±52.72 minutes and 570.4±64.19 minutes, respectively) longer with dexmedetomidine as compared to clonidine (381.8±76.14 minutes & 423.6±90.64 minutes, respectively). The duration of analgesia was longer with dexmedetomidine (623.4±76.44 minutes), as compared to clonidine (471.6±93.92 minutes). Patients who received dexmedetomidine reported a statistically significant decrease in mean heart rate and blood pressure. Conclusion: Dexmedetomidine has better profile in terms of duration of sensory and motor block and duration of analgesia when added as an adjuvant to supraclavicular brachial plexus block.

Keywords: Brachial plexus block, Dexmedetomidine, Clonidine, Lignocaine, Bupivacaine.