Key result
Clonidine added to bupivacaine prolongs postoperative analgesia by ~70% and extends motor blockade vs adrenaline.
Why the study?
Does clonidine compared to adrenaline as an adjuvant to bupivacaine prolong the duration of analgesia and motor blockade in patients undergoing supraclavicular brachial plexus block?
RCT (n=80)
Double-blind
Randomized
No
Does clonidine compared to adrenaline as an adjuvant to bupivacaine prolong the duration of analgesia and motor blockade in patients undergoing supraclavicular brachial plexus block?
Clonidine is a superior adjuvant to adrenaline when added to bupivacaine for supraclavicular brachial plexus blocks, significantly prolonging postoperative analgesia and motor blockade without increasing side effects.
Answers are grounded in this paper and cite their sources.
Supports preferring clonidine over adrenaline in supraclavicular blocks; extends RCT evidence on adjuvants for regional anesthesia.
BACKGROUNDAims and Objectives -In our study we compared the clonidine and adrenaline as adjuvants to bupivacaine in supraclavicular approach to brachial plexus block to prolong the duration of anaesthesia. MATERIALS AND METHODSIt was a prospective, randomised, double-blinded study with eighty patients.The randomly allocated Group A [n = 40] received 40 mL of 0.25% Bupivacaine + 200 micrograms of adrenaline and Group B [n = 40] received 40 mL of 0.25% bupivacaine + 150 micrograms of clonidine in supraclavicular block.The onset of analgesia and motor blockade, duration of surgery, duration of motor blockade and analgesia, VAS score, vital parameters and sedation score were recorded, tabulated and analysed. RESULTSNo difference in the onset of sensory and motor blockade in two groups.Duration of motor blockade and duration of absolute pain free period and duration of post-operative analgesia significantly prolong in clonidine group.No significant side effects were observed in either of the two groups. CONCLUSIONThus, we concluded that addition of clonidine to bupivacaine in supraclavicular approach to brachial plexus block significantly prolong the sensory and motor blockade with no side effects.
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Kumaresan et al. (2017) conducted an RCT in Upper limb surgeries requiring brachial plexus block (n=80). Clonidine vs. Adrenaline 200 µg was evaluated on Duration of postoperative analgesia (minutes) (p=0.0001). Clonidine added to bupivacaine significantly prolonged the duration of postoperative analgesia (959.3 vs 564.75 minutes) and motor blockade compared to adrenaline in supraclavicular brachial plexus block.
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