Comparison of Dexmedetomidine and Clonidine as an Adjuvant to 0.25% Bupivacaine in Peripheral Nerve Stimulator Guided Supraclavicular Brachial Plexus Block in Upper Limb Surgery- A Randomised Single Blind Prospective Study
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 3, Pages 1370-1376
AbstractBackground: The supraclavicular approach to brachial plexus block is the most common peripheral nerve block technique used for upper limb surgeries. Aim of the present study was to evaluate and compare the efficacy of clonidine and dexmedetomidine as an adjuvant to 0.25% bupivacaine in peripheral nerve stimulator guided supraclavicular brachial plexus block in upper limb surgery.
Method: Total 80 patients of ASA grade I and II, age between 25-55 years were enrolled in the study and divided into two groups of 40 each. Group C received 39ml bupivacaine 0.25% (2.5mg/ml) + 1ml clonidine (1µg/ml) and group D received 39ml bupivacaine 0.25% (2.5mg/ml) + 1ml dexmedetomidine (1µg/ml). Parameters were observed include hemodynamic stability, onset time and duration of sensory and motor blockade, duration of analgesia and complications.
Results: Onset of sensory (2.32±1.16min) and motor blockade (5.55±1.50min) was earlier in dexmedetomidine group compared to clonidine group (sensory= 6.52±0.71min and motor= 11.65±1.05min), (p<0.0001). Duration of sensory blockade was 427.75±19.14 minutes in dexmedetomidine group and 226.0±11.72 minutes with clonidine group. Duration of motor blockade was 486.50±28.96 minutes with dexmedetomidine group and 275.25±17.53 minutes with clonidine group. However, the duration of analgesia was 588.25±28.27 minutes with dexmedetomidine group and 341.00±27.34 minutes with clonidine group. Hemodynamic parameters and side effects were comparable between the two drugs.
Conclusion: Dexmedetomidine shortens the onset, prolongs the duration of sensory and motor block, and also provides longer postoperative analgesia as compared with clonidine when used as an adjuvant to bupivacaine in peripheral nerve stimulator guided supraclavicular brachial plexus block.
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