Pradeep Kumar Das1, Raviteja Vallabha2, Sri Harsha Merugu3, Hemnath Babu Kotla4 1,
BACKGROUND
To improve the time of regional anaesthesia many methods have been used.
Epinephrine continues to be the most commonly used drug for this purpose. We
wanted to compare the effects of alpha-adrenergic agonists clonidine and
adrenaline as an adjuvant to ropivacaine in blocking brachial plexus by the
supraclavicular approach in patients undergoing upper limb surgeries.
METHODS
It is a prospective randomised comparative study conducted for 18 months in 40
patients randomly divided into group RA and group RC, conducted on American
Society of Anesthesiology (ASA) I and II patients undergoing upper limb surgeries
under supraclavicular brachial plexus block. In group RA 30 mL of 0.5 %
ropivacaine with 5 microgram / mL of epinephrine was given and in group RC 30
mL of 0.5 % ropivacaine with 1 microgram / Kg of clonidine was given.
RESULTS
On comparing effects of added alpha-adrenergic agonists clonidine and
epinephrine to ropivacaine for supraclavicular brachial plexus block, it was found
that there was no significant difference in the onset of the sensory blockade and
motor blockade in the two groups. Duration of sensory blockade was significantly
more in the clonidine with ropivacaine group when compared with the epinephrine
and ropivacaine. There was no significant difference in haemodynamic responses
between the two groups.
CONCLUSIONS
Supraclavicular approach brachial plexus block is effective in terms of cost and
performance, and the margin of safety along with good postoperative analgesia.
Hence, it can be concluded that the addition of 1 μg / Kg of clonidine to 0.5 %
ropivacaine in supraclavicular brachial plexus block provides a longer duration of
analgesia as compared to 5 μg / mL of epinephrine added to 0.5 % ropivacaine.
