A Randomised Clinical Trial To Compare The Effectiveness Between Bupivacaine And Bupivacaine-Clonidine Combination In Brachial Plexus Block By Supraclavicular Approach

Abstract

Background and objectives : Adjuncts to local anaesthetics for brachial plexus block may enhance the quality and duration of analgesia. Clonidine, an Alpha-2 adrenergic agonist, is known to produce antinociception and enhance the effect of local anaesthetics when given epidurally, intrathecally or in various peripheral nerve blocks. The purpose of this study was to assess the effect of Clonidine added to brachial plexus block by supraclavicular approach. Methods : A prospective, randomized, single blinded study was conducted on 100ASA I or II adult patients undergoing upper limb surgeries under supraclavicular brachial plexus block. Patients were randomly divided into two groups. Patients in Group B (n = 48) were administered 30mL of 0.375% Bupivacaine and Group BC (n= 48) were given 30mL of 0.375% Bupivacaine with Clonidine 1μg/kg. The onsettime and duration of sensory and motor blockade were recorded. Haemodynamic variables (i.e., heart rate, noninvasive blood pressure, oxygen saturation), sedations cores and rescue analgesic requirements were recorded for 24 hrs postoperatively. Results : The onset of sensory and motor block was significantly faster in Group B Ccompared to Group B (P < 0.05). Rescue analgesic requirements were significantly less in Group BC compared to Group B (P < 0.05). Haemodynamics and sedations cores did not differ between groups in the post-operative period. Conclusion: Clonidine (1μg/kg) in combination with 30mL of Bupivacaine (0.375%) hastened onset of sensory and motor block, and improved postoperative analgesia when used in brachial plexus block, without producing any adverse events.