COMPARISON OF DEXMEDETOMIDINE AND CLONIDINE AS AN ADJUVANT TO BUPIVACAINE IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK: A RANDOMISED DOUBLE - BLIND PROSPECTIVE STUDY

Abstract

BACKGROUND: Dexmedetomidine, a potent alpha(2)-adrenoceptor agonist, is approximately eight-times more selective towards the a2-adrenoceptor than clonidine. AIM: Comparison of clonidine and dexmedetomidine as an adjuvant to local anaesthetic in supraclavicular brachial block. MATERIALS AND METHODS: Sixty patients of age group 18-60 years, scheduled for various elective orthopaedic surgeries on forearm and around the elbow under supraclavicular brachial block were divided into two equal groups in a randomized, double-blinded fashion. In group C (n = 30), 30 ml of 0.25% bupivacaine+clonidine 1 mu g/kg; and in group D (n = 30), 30 ml of 0.25% bupivacaine+dexmedetomidine 1 mu g/kg were given. Onset of motor and sensory block, duration of sensory and motor block, quality of block, and duration of postoperative analgesia were recorded. RESULTS: Demographic data and surgical characteristics were similar in both groups. The sensory and motor block onset time was same in both groups (P > 0.05). Sensory and motor blockade durations were longer in group D than in group C (P < 0.001). Duration of postoperative analgesia was longer in group D than in group C (P < 0.001). The 24 h Numerical Rating Pain score was more in Group D as compared to Group C. The quality of anaesthesia was excellent in group D as compared to group C (P < 001). The mean pulse rate and mean blood pressure levels at different time intervals were statistically insignificant between the groups (P > 0.05). CONCLUSIONS: Dexmedetomidine added to bupivacaine for supraclavicular brachial plexus block prolongs the duration of the motor and sensory block and the duration of postoperative analgesia significantly as compared to clonidine.