TO EVALUATE THE EFFECT OF BUPIVACAINE ALONE AND BUPIVACAINE WITH CLONIDINE IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK

BACKGROUND Upper limb surgeries are mostly performed under peripheral blocks, such as the brachial block. Peripheral nerve blocks not only provide intraoperative anaesthesia, but also extend analgesia in the post-operative period without any systemic side-effects. The supraclavicular brachial plexus block provides anaesthesia of the entire upper extremity in the most consistent and time-efficient manner. Supraclavicular brachial plexus blockade provides anaesthesia for surgery of the hand, forearm, elbow and distal humerus. Aim- The present study was conducted to evaluate the effect of bupivacaine alone and bupivacaine with clonidine in supraclavicular brachial plexus block. MATERIALS AND METHODS The prospective, randomised, double-blinded comparative study was conducted with hundred consenting patients between 20 years and 50 years of either sex, which were randomised into 2 groups of fifty each. After enrolment, group assignments were determined by a computer-generated number sequence and were contained in sequentially numbered opaque envelopes to ensure blinding. Group A (n= 50): received 40 mL of 0.25% Bupivacaine with 1 mL of 0.9% normal saline for brachial plexus block. Group B (n= 50): received 40 mL of 0.25% Bupivacaine with 2 mu g/kg body weight of Clonidine with normal saline to make a total of 1 mL as brachial plexus block. RESULTS The results were analysed using appropriate statistical test. The data compiled were analysed with GraphPad InStat (R) 3 Statistical Software. For qualitative data, Chi-square test was used. Quantitative data were analysed using student t-test. P-value of 0.05 was considered to be insignificant. Demographic variables (Age, sex, weight in kg) were comparable between the two groups with the P-value remaining insignificant when comparison was done between two groups; age in yrs., sex (M: F), weight in kg, all p-value non-significant and patient's vital parameters (Heart rate, systolic BP, diastolic BP, MAP, SpO2 were all found to be insignificant). The difference in the mean time of onset of sensory and motor block between Group A and Group B was statistically significant, i.e. p < 0.0001. The difference in the mean duration of sensory block and motor block between Group A and Group B was statistically significant, i.e. p < .0001. The difference in the mean duration of analgesia between Group A and Group B was statistically significant with p-value < 0.0001. The Ramsay sedation score at various time intervals between the two groups were either equal or with a difference, which was not statistically significant with p-value > 0.05. No complications or any other adverse events were eminent in either of the groups. CONCLUSION Clonidine (2 mu g/kg body weight) is superior to bupivacaine alone as an adjunct to local anaesthetic solution when administered into brachial plexus sheath for perioperative analgesia during upper limb surgery.