Email this article Comparison of clonidine and dexmedetomidine as an adjuvant to bupivacaine in supraclavicular brachial plexus block for upper limb orthopedic procedures
Abstract
Background: Supraclavicular brachial plexus block is used commonly for upper limb orthopedic procedures. Among the adjuvants used to improve the quality of block induced by bupivacaine the alpha 2 agonists are of new interest. This study was done to compare dexmedetomidine and clonidine as adjuvants to bupivacaine for supraclavicular brachial plexus block in upper limb orthopedic surgeries.
Methods: 60 ASA I/II patients aged between 20 and 50 years undergoing upper limb orthopedic procedures were selected and divided into two groups of 30 each. Group C received 35 ml of 0.375% Bupivacaine and clonidine 2µg/kg while Group D received 35 ml of 0.375% bupivacaine and dexmedetomidine 2 µg/kg. Onset time to sensory and motor blockade, vitals, complete duration of motor and sensory block, total duration of analgesia and side effects were noted.
Results: The mean time of onset for sensory block and motor block in Group D was lower when compared to Group C. Except at 5th minute the pulse rate and mean arterial pressure were lower in Group D when compared to Group C. The mean time for total duration of sensory block and motor block was more in Group D when compared to Group C. The total duration of analgesia was higher in Group D than in Group C.
Conclusions: The addition of dexmedetomidine to bupivacaine during supraclavicular brachial plexus block produces a shorter onset of time to sensory and motor block with prolonged duration of analgesia when compared to clonidine added to bupivacaine.
Keywords
Full Text:
PDFReferences
Malinzak EB, Gan TJ. Regional anesthesia for vascular access surgery. Anesth Analg. 2009;109(3):976-80.
Förster, JG, Rosenberg PH. Clinically useful adjuvants in regional anesthesia. Current Opinion in Anesthesiology. 2003;16:477-86.
Gabriel JS. Gordin V. Alpha 2 agonists in regional anesthesia and analgesia. Current Opinion in Anesthesiology. 2001;6:751-2.
Jadon A, Panigrahi MR, Parida SS, Chakraborty S, Agrawal PS, Panda A. Buprenorphine improves the efficacy of bupivacaine in nerve plexus block: A double blind randomized evaluation in subclavian perivascular brachial block. J Anaesth Clin Pharmacol. 2009;25(2):207-10.
O'Donnell BD, Iohom G. An estimation of the minimum effective anesthetic volume of 2% lidocaine in ultrasound-guided axillary brachial plexus block. Anesthesiology. 2009;111:25-9.
Swami SS, Keniya VM, Ladi SD, Rao R. Comparison of dexmedetomidine and clonidine (α2 agonist drugs) as an adjuvant to local anaesthesia in supraclavicular brachial plexus block: A randomised double-blind prospective study. Indian J Anaesth. 2012;56:243-97.
Gandhi R, Shah A, Patel I. Use of dexmedetomidine
along with bupivacaine for brachial plexus block. Natl J Med Res. 2012;2(1):67-9.
Agarwal S. Dexmedetomidine prolongs the effect of bupivacaine in supraclavicular brachial plexus block. J Anaesthesiol clin Pharmacol. 2014;30:36-40.
Ammar AS, Mahmoud KM. Ultrasound-guided single injection infraclavicular brachial plexus block using bupivacaine alone or combined with dexmedetomidine for pain control in upper limb surgery: a prospective randomized controlled trial. Saudi J Anaesth. 2012;6:109-14.
Kaygusuz K. Effects of adding dexmedetomidine to levobupivacaine in axillary brachial plexus block. Curr Ther Res Clin Exp. 2012;73:103-11.
Ahmad Dar F, Najar MR, Jan N. Dexmedetomidine Added to Ropivacaine Prolongs Axillary Brachial Plexus Block. International journal of biomedical and advance research. 2013;4(10):713-8.
Solanki S, Bharti N, Batra Y, Jain A, Kumar P, Nikhar S. The analgesic effect of intrathecal dexmedetomidine or clonidine, with bupivacaine, in trauma patients undergoing lower limb surgery: a randomised, double-blind study. Anaesth Intensive Care. 2013;41(1):46-5.
