A COMPARATIVE STUDY OF EFFECTS OF CLONIDINE ADDED TO ROPIVACAINE VERSUS PLAIN ROPIVACAINE DURING SUPRA CLAVICULAR BRACHIAL PLEXUS BLOCK

BACKGROUND: Brachial plexus block provides minimal systemic impairment & excellent localized postoperative analgesia for upper extremity surgery. Local anaesthetic agents such as lignocaine, bupivacaine & ropivacaine are widely used along with adjuvant to improve the quality, onset & duration of block and to decrease postoperative analgesic requirement and systemic side effects. Adjuvant like alpha-2 agonist (clonidine), acetylcholineesterase inhibitors, opioids etc. are been added to LA's. Clonidine is an imidazoline derivative with alpha 2-adrenergic agonistic activity. There has been seen a potentially clear synergism between clonidine & ropivacaine in various regional block anaesthesia. AIM: To compare the efficacy of Clonidine as adjuvant to Ropivacaine for Supraclavicular brachial plexus block. METHODS AND MATERIAL: This double blind randomized controlled study was done in Mahatma Gandhi Medical College & Hospital, Jaipur. A total of 60 ASA Grade I to IV patient were taken & randomly allocated into 2 groups comprising 30 patients in each. Group I (control group) included patients which were given 30 ml of 0.75% ropivacaine (225 mg) and Group II (study group) included patients which were given 30 ml of 0.75% ropivacaine (225 mg) with 0.4 ml (60 mu g) clonidine. Sensory function was tested using pinprick and motor with concomitant inability to move the wrist and hand and the first analgesic request was noted. Postoperatively the pain was measured using VAS score (0 to 10). Statistical Analysis: Results were expressed as mean and standard deviation. P value of < 0.05 was considered statistically significant. RESULTS: The mean VAS was found lower in group II when pain was first reported and at 5, 6 & at 9 hr than group I. Duration of sensory block analgesia lasted longer in group II which were given clonidine along with LA. There was no statistically significant difference in onset time, in degree of sedation, and other hemodynamic variables. CONCLUSIONS: It can be postulated that clonidine produces longer analgesia time when used as an adjuvant to Ropivacaine for Supraclavicular brachial plexus block.