European Journal of Molecular & Clinical Medicine

Abstract

Introduction: Prolongation of axillary block is desirable in many instances to allow more prolonged or extensive surgery and decrease the requirement of further analgesics
Aims and Objectives: This trial was a non-randomised control study to examine the effect of adding clonidine to bupivacaine for Axillary block in patients undergoing orthopedic surgery of forearm or hand in prolonging the duration of analgesia.
Materials and methods: A total of 110 adult patients of ASA 1,2,3 class were alternately allocated to  each of two groups. Group A received 0.25% Bupivacaine 40mL + 1 ml 150µg clonidine  and Group B received 0.25% Bupivacaine 40mL + 1 ml 0.9% saline via perivascular Axillary block.
Results: The patient groups were comparable in terms of age, gender, co-morbidities and ASA class. In the bupivacaine clonidine group, analgesia was prolonged by a mean 208 minutes compared to bupivacaine alone. Onset of sensory and motor blockade was shortened by an average of 2.7 min and 3 min in the clonidine group. Duration of sensory block was a mean of  503.3125.9 minutes  in bupivacaine- clonidine group, while in bupivacaine only group it was 287.182.9 minutes. This shows a significant prolongation in the clonidine group by about 216.2 minutes. Mean duration of motor block in bupivacaine-clonidine group was 409.8  minutes while in bupivacaine only group it was 259.674.8 minutes. This denotes a mean prolongation of 150.2 min in the clonidine group. Side effects noted in our study were hypotension, bradycardia and sedation incidence of which were 7.3%,9.1% and 36.3% respectively in the bupivacaine-clonidine group  and 1.8%,3.6% and 9.1% respectively in the bupivacaine only group.
Conclusion:  Clonidine is a useful adjuvant to bupivacaine for Axillary block. It significantly prolongs analgesia, duration of sensory and motor block. It also shortens the onset of sensory and motor block, although by a less significant amount.