A COMPARATIVE STUDY OF SUPRACLAVICULAR BRACHIAL PLEXUS BLOCKADE WITH BUPIVACAINE 0.5% VERSUS BUPIVACAINE AND CLONIDINE IN UPPER LIMB SURGERIES

Dr. A. Christopher; Dr. G. Visala; Dr. Surya Narayana

Volume : VI, Issue : V, May - 2016

A COMPARATIVE STUDY OF SUPRACLAVICULAR BRACHIAL PLEXUS BLOCKADE WITH BUPIVACAINE 0.5% VERSUS BUPIVACAINE AND CLONIDINE IN UPPER LIMB SURGERIES

Dr. A. Christopher, Dr. G. Visala, Dr. Surya Narayana

Abstract :

Background and Objectives: Several studies have demonstrated that certain drugs when used as adjuncts to local anaesthetics for achial plexus block enhances the quality and duration of analgesic clonidine, an alpha–2 adrenergic agonist is such a drug known to produce antinociception and enhance the effect of local anaesthetics when given intrathecally, epidurally or in peripheral nerve blocks. This study is undertaken to assess the efficacy of clonidine when added to bupivacaine in achia plexus block by Supraclavicular approach. Methods: A prospective, randomized double blinded study was carried out in Government General Hospital, Kurnool, in which 60 patients (ASA I or II) aged 18 to 60 years of either sex undergoing elective upper limb surgeries lasting more than 30 minutes were included. Patients were randomly divided into two groups of 30 each, named as B (bupivacaine) group and BC (Bupivacaine clonidine) group. Group B received 25 ml of 0.5% bupivacaine and 1 ml of normal saline and Group BC received 25 ml of 0.5% bupivacaine and clonidine 1 μg/kg. The onset time and duration of sensory and motor blockade were recorded. Haemodynamic variables (i.e. heart rate, non–invasive blood pressure, O2 saturation) and sedation scores are recorded for 24 hours post operatively. Results: The onset of sensory and motor block was significantly faster in group BC compared to group B (p < 0.05). The mean time duration of sensory blockade and motor blockade was prolonged in group BC compared to group B (p < 0.05). Haemodynamic variables and sedation scores did not differ between two groups in the post–operative period. Conclusion: The present study concludes that addition of clonidine 1 (μg/kg) to bupivacaine (0.5%, 25 ml) in achial plexus block hastened onset of sensory and motor block and prolonged duration of analgesia and also motor blockade without any significant clinical side effects