Assessment of supraclavicular brachial plexus block with clonidine as adjuvant in upper limb surgery

Abstract

Background: Acute postoperative pain is the result of a complex physiological reaction to tissue injury. Clonidine is a selective alpha adrenergic receptor agonist and it has been used as an adjunct to LA in various doses. The present study was conducted to compare supraclavicular brachial plexus block with clonidine as adjuvant in upper limb surgery. Materials & Methods: 45 ASA I and II patients posted for unilateral upper limb surgery of both genders were randomly divided into 3 groups of 15 each. Group I received 15 mL of 2% lignocaine with adrenaline and 15 mL of 0.5% bupivacaine with 0.6 mL of normal, group II received 45 µg of clonidine and group III received 90 µg of clonidine along with the local anaesthetics. The time taken for onset and the duration of sensory and motor blocks, the time required for rescue analgesia was noted. Results: The mean age (years) was 32.1, 31.8 and 32.0, weight (Kgs) was 62.8, 64.5 and 65 and height (cm) was 157.2, 155.9 and 154.8 in group I, II and III respectively. In group I, group II and group III, mean sensory onset (minutes) was 13.4, 6.8 and 5.9, sensory duration (minutes) was 5.2, 6.0 and 8.3, motor onset (minutes) was 14.2, 7.2 and 6.5, motor duration (minutes) was 3.7, 5.2 and 8.1 and rescue analgesia (hours) was 4.7, 7.1 and 11.2 respectively. The difference was significant (P< 0.05). Conclusion: Clonidine is an attractive alternative as an adjuvant with bupivacaine and lignocaine in the ultrasound guided supraclavicular block for upper limb surgical procedures.