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Adjuvants in blockade of the brachial plexus can lengthen patient care and hasten the ambulation with stable hemodynamics. Brachial plexus block has possible complications like local anaesthetic systemic toxicity, pneumothorax, nerve injury etc. which can be overcome by use of ultrasound guidance with adjuvants like dexmedetomidine and clonidine for postoperative analgesia. Ropivacaine has higher motor to sensory differentiation and lesser cardiotoxicity. A prospective blinded study comprising of 90 subjects posted for elective upper extremity surgeries. To compare the onset, duration of sensory and motor blockade and analgesia of 0.5% ropivacaine with clonidine 1mg.kg- and 0.5% ropivacaine with dexmedetomidine 1mg.kg-. Ninety patients aged 18 – 60yrs were chosen and randomly allocated into two groups of 45 participants. 20mL of 0.5% Ropivacaine and dexmedetomidine 1mg.kg-was administered to Group A and Group B received Ropivacaine and clonidine 1mg.kg-. In Group A, 73.3% of the subjects showed onset of sensory block of 8 minutes while it was 10 minutes in 26.7% of the subjects. In Group B, 44.4% of the patients showed onset of sensory block of 8 minutes, and 26.7% of the patients showed onset of sensory block of 10 min. Statistically, subjects in Group A showed decrease in onset of block and a higher mean duration of sensory and motor block in contrast to Group B. Addition of dexmedetomidine to 0.5% ropivacaine in supraclavicular brachial plexus block decreased the time of onset of sensory and motor block and extended the period of analgesia.
Abhishek et al. (Fri,) studied this question.