title: Clonidine as an adjuvant for ultrasound guided supraclavicular brachial plexus block for upper extremity surgeries under tourniquet: A clinical study.
abstract: OBJECTIVE
  Clonidine has been used as an adjuvant to local anesthetic to extend the duration of block. The present study was aimed to compare the onset and duration of sensory and motor blockade of 0.75% ropivacaine alone or in combination with clonidine during ultrasound guided supraclavicular brachial plexus block for upper extremity surgeries under tourniquet.
  
  
  METHODS
  Sixty four adult American Society of Anesthesiologist grade 1 and 2 patients, scheduled for upper extremity surgeries were randomized to receive either 19.8 mL of 0.75% ropivacaine with 0.2 mL of normal saline (Group R) or 0.2 mL (30 μg) of clonidine (Group RC) in supraclavicular block. Onset and duration of sensory and motor blockade was compared. The hemodynamic variability, sedation, respiratory adequacy and any other adverse effects were also recorded.
  
  
  RESULTS
  Ultrasound helped to visualize the nerves, needle and spread of local anesthetic at the brachial plexus block site. There was no statistically significant difference in the onset of sensory and motor blockade between the groups. Surgical anesthesia was achieved at the mean time of 20 min in all patients. Prolonged post-operative analgesia (mean duration 956 min) was observed in RC group as compared with R group (736 min). No complication of technique or adverse effect of ropivacaine and clonidine was reported.
  
  
  CONCLUSIONS
  Clonidine as an adjuvant to ropivacaine for ultrasound guided supraclavicular brachial plexus enhanced duration of post-operative analgesia. There was no incidence of vessel puncture or pneumothorax.
authors.affiliation: Departments of Anaesthesiology & Critical Care, Netaji Subhash Chandra Bose Subharti Medical College, Swami Vivekananda Subharti University, Subhartipuram, Meerut, Uttar Pradesh, India.
authors.forename: Kumkum
authors.initials: K
authors.lastname: Gupta
authors.affiliation: Departments of Anaesthesiology & Critical Care, Netaji Subhash Chandra Bose Subharti Medical College, Swami Vivekananda Subharti University, Subhartipuram, Meerut, Uttar Pradesh, India.
authors.forename: Vaibhav
authors.initials: V
authors.lastname: Tiwari
authors.affiliation: Departments of Radio-diagnosis, Imaging & Interventional Radiology, and Netaji Subhash Chandra Bose Subharti Medical College, Swami Vivekananda Subharti University, Subhartipuram, Meerut, Uttar Pradesh, India.
authors.forename: Prashant K
authors.initials: PK
authors.lastname: Gupta
authors.affiliation: Departments of Anaesthesiology & Critical Care, Netaji Subhash Chandra Bose Subharti Medical College, Swami Vivekananda Subharti University, Subhartipuram, Meerut, Uttar Pradesh, India.
authors.forename: Mahesh Narayan
authors.initials: MN
authors.lastname: Pandey
authors.affiliation: Departments of Anaesthesiology & Critical Care, Netaji Subhash Chandra Bose Subharti Medical College, Swami Vivekananda Subharti University, Subhartipuram, Meerut, Uttar Pradesh, India.
authors.forename: Apoorva B
authors.initials: AB
authors.lastname: Singhal
authors.affiliation: Departments of Anaesthesiology & Critical Care, Netaji Subhash Chandra Bose Subharti Medical College, Swami Vivekananda Subharti University, Subhartipuram, Meerut, Uttar Pradesh, India.
authors.forename: Garg
authors.initials: G
authors.lastname: Shubham
keywords: Clonidine; ropivacaine; supraclavicular block; ultrasound