Key result
Dexamethasone added to ropivacaine significantly prolonged the duration of analgesia compared to clonidine (503.92 vs 413.50 minutes, p=0.000), though clonidine provided a faster onset of sensory and motor block.
Why the study?
Using adjuvants to enhance regional block intensity is common, but comparative data evaluating dexamethasone versus clonidine as adjuvants to ropivacaine in supraclavicular brachial plexus block were needed.
Does dexamethasone compared to clonidine as an adjuvant to ropivacaine improve block characteristics and prolong analgesia in patients undergoing elective upper limb surgery?
RCT (n=120)
Randomly divided
No
Does dexamethasone compared to clonidine as an adjuvant to ropivacaine improve block characteristics and prolong analgesia in patients undergoing elective upper limb surgery?
Absolute Event Rate: 503.92% vs 413.5%
p-value: p=0.000
Dexamethasone as an adjuvant to ropivacaine in supraclavicular blocks significantly prolongs analgesia without adverse effects, whereas clonidine provides faster block onset but is associated with bradycardia and hypotension.
May support preferring dexamethasone for longer analgesia in supraclavicular blocks; leaves open confirmation via larger randomized trials.
Background/Aim: Enhancing the intensity of block by using adjuvant is the mainstay now a days in various regional block for surgery. Our primary objective was to compare the dexamethasone and clonidine as adjuvant to ropivacaine in supraclavicular block. Supraclavicular brachial plexus block provides excellent perioperative analgesia in upper extremity surgeries. Various adjuvants can be added to local anesthetics to enhance the effect of block. The main objective in the management of postoperative pain is minimizing the dose of analgesic to reduce side effects and provide adequate analgesia, shorten hospital stay, reduce hospital cost, and increase patient satisfaction. Methodology: One hundred twenty patients going for elective upper limb surgery of ASA grade I & ASA II in the age group 18 – 60 years were divided in the two groups of 60 each. Groups 1 were given Ropivacaine 0.5% 30 ml with 8 mg Dexamethasone, and Groups II were given Ropivacaine 0.5% 30 ml with 75 mcg Clonidine for supraclavicular block using peripheral nerve stimulator. Onset of sensory and motor block, duration of motor block, duration of analgesia, number of rescue analgesia, sedation score, post-operative pain and adverse effects were observed.
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Agarwal et al. (2022) conducted an RCT in Elective upper limb surgery (n=120). Dexamethasone as adjuvant to ropivacaine vs. Clonidine 75 mcg added to 30 ml 0.5% Ropivacaine was evaluated on Duration of analgesia (minutes) (p=0.000). Dexamethasone added to ropivacaine significantly prolonged the duration of analgesia compared to clonidine (503.92 vs 413.50 minutes, p=0.000), though clonidine provided a faster onset of sensory and motor block.
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