Vallem Balasubramanyam, Sai Suraj K. N, Talisetti Jamuna
BACKGROUND Brachial plexus blockade is considered as cornerstone of regional anaesthesia practice. Ropivacaine is a new amide, long acting, pure S (-) enantiomer and local anaesthetic. This study was done to compare clonidine and dexmedetomidine as an adjuvant to 0.75% ropivacaine in supraclavicular brachial plexus block. MATERIALS AND METHODS A prospective randomised double-blind study was done in 80 patients of American Society of Anesthesiologist (ASA) grade I and II undergoing elective upper limb surgeries under supraclavicular block. Patients were randomised into 2 groups. Group 1 (n=40) received 30 mL of 0.75% ropivacaine with clonidine 1 mcg/kg and group 2 (n=40) received 30 mL of 0.75% ropivacaine with dexmedetomidine 1 mcg/kg. Onset and recovery time of sensory and motor block, duration of analgesia and quality of block, haemodynamic variables and level of sedation were studied in two groups. RESULTS Sensory and motor block onset times were shorter in group 2 (onset of sensory block was 4.9 ± 1.08 minutes and onset of motor block was 8.9 ± 1.41 minutes) than in group 1 (onset of sensory block was 10.7 ± 4.05 minutes and onset of motor block took 12.1 ± 4.11 minutes) (p value <0.0001). Sensory and motor block durations and duration of analgesia were longer in group 2 than in group 1 (p<0.0001). Blood pressure and heart rate were lower in group 2 as compared to group 1 (p value <0.0001). The number of patients achieving grade 4 quality of block was higher in group 2 as compared to group 1. CONCLUSION Dexmedetomidine (1 mcg/kg) hastens the onset of sensory and motor block, prolongs the duration of sensory and motor block, enhances the quality of block and sedation and also prolongs duration of analgesia as compared with clonidine (1 mcg/kg) when used as an adjuvant to 0.75% ropivacaine in supraclavicular block.
