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. 2013 Oct;29(4):491-5.
doi: 10.4103/0970-9185.119147.

Brachial plexus block: Comparison of two different doses of clonidine added to bupivacaine

Santvana Kohli  1 , Manpreet Kaur, Sangeeta Sahoo, Homay Vajifdar, Pramod Kohli
Affiliations

Brachial plexus block: Comparison of two different doses of clonidine added to bupivacaine

Santvana Kohli et al. J Anaesthesiol Clin Pharmacol. 2013 Oct.

Abstract

Background: The role of clonidine as an adjuvant to local anesthetic agents in brachial plexus block (BPB) has been extensively studied. However, till date there has been no consensus about the ideal dose of clonidine for this purpose. This study was carried out to evaluate two doses of clonidine-1 and 2 g/kg, added to 0.5% bupivacaine, with regard to onset and duration of sensorimotor blockade, hemodynamic effects, postoperative analgesia, and adverse effects.

Materials and methods: Sixty adult patients undergoing upper limb surgeries were randomly allocated into two groups. Thirty patients received 1 g/kg clonidine (group I) and the rest received 2 g/kg clonidine (group II) added to 30 mL of 0.5% bupivacaine through nerve stimulator-guided supraclavicular BPB. The onset and duration of sensorimotor blockade, hemodynamic variables, duration of analgesia, level of sedation, and adverse effects was assessed.

Results: The onset of sensorimotor block was earlier in group II (9.9 ± 4.1 min for sensory block and 13.2 ± 6.7 min for motor block) than in group I (15.9 ± 6.8 min for sensory block and 18.5 ± 7.8 min for motor block). The duration of analgesia was also prolonged in patients receiving the higher dose (21.0 ± 2.96 h vs. 14.9 ± 3.0 h). Although hemodynamics remained comparable in both the groups, incidence of hypotension and bradycardia was higher in group II as compared to group I. The sedation was clinically and statistically more in group II patients (43% vs. 17%).

Conclusion: Higher dose of clonidine in BPB hastens the onset, prolongs the duration of sensorimotor blockade and postoperative analgesia without significant hemodynamic alterations. It also causes more sedation, which although ensures patient comfort in most cases, but might be undesirable in certain situations.

Keywords: Adjuvant; brachial plexus block; bupivacaine; clonidine; postoperative analgesia.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Comparison of intraoperative vitals (heart rate, mean arterial pressure, and oxygen saturation) in between group I and group II
Figure 2
Figure 2
Comparison of postoperative vitals (heart rate, mean arterial pressure, and oxygen saturation) in between group I and group II
Figure 3
Figure 3
Distribution of patients according to sedation score
Figure 4
Figure 4
Distribution of patients according to modified Bromage score
Figure 5
Figure 5
Postoperative distribution of patients according to visual analog scale (VAS) ≥4
See this image and copyright information in PMC

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