Addition of clonidine or lignocaine to ropivacaine for supraclavicular brachial plexus block: a comparative study.
BACKGROUND
Clonidine is used with local anaesthetics to improve analgesia. However, the improvement conferred when clonidine is used together with ropivacaine is controversial. Thus, the present study aimed to evaluate the improvement in analgesia when clonidine is used together with ropivacaine for supraclavicular brachial plexus block.


METHODS
This was a prospective, randomised, double-blind controlled study. A total of 75 patients who were scheduled to undergo supraclavicular block were randomly assigned into three groups (i.e. clonidine, lignocaine and control groups) of 25. Patients in all three groups received 20 mL of 0.75% ropivacaine. In addition to that, patients in the clonidine group received 1 mL of clonidine (150 μg) plus 9 mL of saline, patients in the lignocaine group received 10 mL of 2% lignocaine with adrenaline (1:200,000), and patients in the control group received 10 mL of saline. The characteristics of anaesthesia and analgesia for these three groups were assessed.


RESULTS
The addition of 2% lignocaine with adrenaline to ropivacaine led to earlier onset of the sensory block (by 4.88 mins), but no increase in the duration of analgesia when compared to analgesia using ropivacaine alone. The addition of clonidine to ropivacaine led to earlier onset of sensory and motor blocks (by 2.88 mins and 3.28 mins, respectively), as well as an increased duration of sensory and motor blocks (by 222.64 mins and 192.92 mins, respectively) when compared to analgesia using ropivacaine alone. The total duration of analgesia was increased by 208.24 mins with clonidine when compared to analgesia using ropivacaine alone. There were no significant differences in sedation score and no side effects in all three groups.


CONCLUSIONS
When compared to the use of ropivacaine alone, the addition of 150 μg clonidine to ropivacaine for brachial plexus block achieved earlier analgesic onset and improved duration of analgesia, without unwanted side effects.
Bhatia
B
Rohan
Department of Anaesthesiology, Himalayan Institute of Medical Sciences, Swami Ram Nagar, Dehradun, Uttarakhand 248140, India. dryspayal05@gmail.com.
Payal Yashwant
PY
Singh
Khurana
K
Gurjeet
D000328:Adult; D000577:Amides / Q000008:administration & dosage*; D000698:Analgesia / Q000379:methods; D000758:Anesthesia / Q000379:methods; D000777:Anesthetics / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D000959:Antihypertensive Agents / Q000008:administration & dosage; D065527:Brachial Plexus Block / Q000379:methods*; D003000:Clonidine / Q000008:administration & dosage*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination / Q000379:methods; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D000077212:Ropivacaine
D000577:Amides; D000777:Anesthetics; D000779:Anesthetics, Local; D000959:Antihypertensive Agents; D000077212:Ropivacaine; D008012:Lidocaine; D003000:Clonidine