Key result
Dexmedetomidine prolongs post-operative analgesia by ~3 hours versus clonidine in upper limb orthopedic surgeries.
Why the study?
Efforts continue to find better and safer local anaesthetics with adjuvants for supraclavicular brachial plexus block, with levobupivacaine and alpha 2 agonists as key options.
Does dexmedetomidine compared to clonidine prolong the duration of analgesia in adults undergoing upper limb orthopaedic surgeries with supraclavicular brachial plexus block?
RCT (n=60)
Double-blind
Sealed envelopes
No
Does dexmedetomidine compared to clonidine prolong the duration of analgesia in adults undergoing upper limb orthopaedic surgeries with supraclavicular brachial plexus block?
Dexmedetomidine is more effective than clonidine as an adjuvant to levobupivacaine in prolonging postoperative analgesia for supraclavicular brachial plexus blocks.
Favors dexmedetomidine over clonidine to prolong analgesia in supraclavicular blocks; extends RCT evidence for alpha-2 agonists in upper limb surgery.
Introduction: There are always efforts to find better and safer local anaesthetics along with adjuvants for supraclavicular brachial plexus block. Levobupivacaine has strongly emerged as a safer alternative for regional anaesthesia than its racemic sibling bupivacaine. Alpha 2 agonists are combined with local anaesthetics to improve the quality of regional anaesthesia. Method: A prospective randomized study was carried out which included 60 adult patients between the ages of 18-65 years of ASA grade I and II who underwent upper limb orthopaedic surgeries. Group A received 30 ml of 0.5% levobupivacaine with 150µg of clonidine and Group B received admixture of 30 ml of 0.5% levobupivacaine with 100 µg of Dexmedetomidine. Onset, duration of sensory and motor blockade and duration of analgesia were observed. Results: Duration of postoperative analgesia in group A was 14.36±0.36 minutes and in group B was 16.90±2.29 minutes. Hence from the above observation, the duration of analgesia in group B is longer than group A which is statistically highly significant (p<0.001). Conclusion: Dexmedetomidine as an adjuvant 0.5% levobupivacaine is more effective in prolonging the duration of sensory and motor block and post operative analgesia compare to clonidine as an adjuvant to 0.5% levobupivacaine.
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Kataria et al. (2017) conducted an RCT in Upper limb orthopaedic surgeries (n=60). Dexmedetomidine vs. Clonidine 150 µg was evaluated on Duration of post-operative analgesia (hours) (p=<0.001). Dexmedetomidine as an adjuvant to levobupivacaine significantly prolonged the duration of post-operative analgesia compared to clonidine in patients undergoing upper limb orthopaedic surgeries.
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