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BACKGROUND Effective postoperative pain control is an important part of postoperative care which leads to shortened hospital stays, reduced hospital costs and increased patient satisfaction. Variety of adjuvants has been used along with local anaesthetics in regional blocks to increase the duration of effective analgesia. We have conducted a prospective study to compare the effect of clonidine and dexmedetomidine as additives to 30 ml of 0.5 % ropivacaine in supraclavicular brachial plexus block for upper limb orthopaedic surgeries. METHODS A prospective study was conducted among 50 patients belonging to ASA 1 or 2 undergoing upper limb orthopaedic surgeries under supraclavicular brachial plexus block. Patients who received 1mcg/kg clonidine added to 30 ml of 0.5 % ropivacaine in supraclavicular brachial plexus block were taken into Group A. Patients who received 1mcg/kg dexmedetomidine added to 30 ml of 0.5 % ropivacaine in supraclavicular brachial plexus block were taken into Group B. Sensory block – onset, duration; motor block – onset and duration; duration of analgesia were monitored and recorded. Data analysed using IBM SPSS (version 17) software. P value < 0.05 was considered as statistically significant. RESULTS Onset of sensory block was 9.04 ± 1.74 min in clonidine group and 12.0 ± 2.00 min in dexmedetomidine group which was statistically significant. Onset of motor block was 11.80± 1.87 min in clonidine group and 15.48 ± 2.08 min in dexmedetomidine group which was statistically significant. Duration of motor block was 502.8 ± 60.9 min in clonidine group and 566.0 ± 59.6 min in dexmedetomidine group which was statistically significant. Duration of sensory block was 589.2 ± 56.6 min in clonidine group and 673.6 ± 53.4 min in dexmedetomidine group which was statistically significant. Duration of analgesia was 665.20 ± 52.20 min in clonidine group and 760.40 ± 48.20 min in dexmedetomidine group which was statistically significant. CONCLUSIONS The addition of clonidine to 0.5 % ropivacaine in supraclavicular brachial plexus block significantly reduces the onset of sensory block and motor block whereas addition of dexmedetomidine significantly prolongs the duration of sensory and motor block compared to clonidine. Addition of dexmedetomidine also prolongs the duration of analgesia compared to clonidine. KEY WORDS Supraclavicular Brachial Plexus Block; Ropivacaine; Clonidine; Dexmedetomidine.

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BACKGROUND Direct laryngoscopy and endotracheal intubation have been a part of the mainstay modalities of providing anaesthesia. Both lignocaine and dexmedetomidine have proven effects of attenuating the stress response to laryngoscopy and intubation. This study compared the efficacy in attenuating the pressor response of lignocaine when given at 1.5 mg/kg and dexmedetomidine given at 0.5 µg/kg body weight. METHODS This is a prospective observational study involving 80 patients of both sexes who underwent elective surgeries under general anaesthesia. They were divided into two groups: Group D and Group L. Group D received dexmedetomidine 0.5 µg/kg body weight slow IV, 10 minutes prior to laryngoscopy and Group L received 2% preservative free lignocaine 1.5 mg/kg body weight i.v. bolus ninety seconds prior to laryngoscopy. Hemodynamic changes like heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean blood pressure (MBP) were monitored before induction (baseline), post induction and at 1, 5, and 10 minutes after endotracheal intubation. Structured proforma was formulated and obtained data was analysed using STATA software. RESULTS In the lignocaine group, heart rate, SBP, DBP and MAP increased and gradually returned to baseline value. The dexmedetomidine group showed highly significant attenuation of sympathetic response to laryngoscopy and intubation compared to lignocaine groups. CONCLUSIONS The study results go on to demonstrate that dexmedetomidine infusion is better at attenuating the pressor response to intubation than preservative free intravenous lignocaine when given prior to induction. KEY WORDS Stress Response, Direct Laryngoscopy, Intubation, Dexmedetomidine, Lignocaine.

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