BACKGROUND Supraclavicular block provides anaesthesia for upper extremity in the most consistent andf efficient manner of any brachial plexus technique. Adjuvants when added to local anaesthetics enhance the onset and prolongs the duration of block. α2 agonists produce analgesia, sympatholysis and sedation, hence considered as effective adjuvant. The aim of this study is to compare the efficacy and safety of two α2 agonists, i.e. clonidine and dexmedetomidine as an adjuvant for brachial plexus block. MATERIALS AND METHODS It was a prospective, randomised and double-blind study. Sixty patients of ASA grades I and II undergoing forearm surgeries were randomly divided into two groups of 30 patients each. Group C patients received Inj. Bupivacaine (0.5%) 2 mg/kg + Inj. Lignocaine (2%) 5 mg/kg with adrenaline + Inj. Clonidine 1 μg/kg. Group D patients received Inj. Bupivacaine (0.5%) 2 mg/kg + Inj. Lignocaine (2%) 5 mg/kg with adrenaline + Inj. Dexmedetomidine 1 μg/kg. Parameters noted were onset, completion and duration of sensory and motor block, duration of analgesia, Ramsay sedation score, vital parameters and complications if any. Results were analysed by student's unpaired 't' test and chi-square test. RESULTS Onset and time for complete sensory and motor block was significantly faster in the dexmedetomidine group when compared to the clonidine group. The total duration of sensory and motor block and duration of analgesia was also significantly longer in Group D. Both the groups had stable haemodynamics. No complications or side effects were observed in both the groups. CONCLUSION Dexmedetomidine can be used as an adjuvant, alternative to clonidine in supraclavicular brachial plexus block with prolongation of both sensory and motor block, and without any haemodynamic instability and systemic side effects.

BACKGROUNDAdjuvants/adjuncts are the drugs, which when added to local anaesthetics tend to improve the quality of block and increase duration of analgesia. The purpose of this study was to compare two novel alpha-2 agonist clonidine and dexmedetomidine when added as adjuvant to 0.5% ropivacaine in infraclavicular vertical brachial plexus block in respect to onset, duration of sensory and motor block along with duration of analgesia. MATERIALS AND METHODSA total of 60 patients confirming to inclusion criteria, undergoing elective upper limb surgeries under BPB in VIMSAR, Burla, were enrolled for the study over a period of one year. Sensory block was evaluated by Hollmen scale. Onset time of sensory block, time for complete sensory block and total duration of sensory block were recorded. Motor block was evaluated by using Bromage scale. Onset time of motor block, time for complete motor block and total duration of motor block were recorded. Level of sedation was assessed using the Ramsay sedation score. Postoperatively, sensory block and motor block and postoperative pain (by visual analogue scale) were assessed. RESULTSThe sensory motor block was significantly rapid and the duration of analgesia was significantly prolonged in dexmedetomidine group as compared to clonidine group. CONCLUSIONAddition of 1 μg/kg of dexmedetomidine as adjuvant to 0.5% ropivacaine for infraclavicular vertical brachial plexus block is better as compared to 1 μg/kg of clonidine. KEYWORDSRopivacaine, Dexmedetomidine, Clonidine, Infraclavicular Vertical Brachial Plexus Block. HOW TO CITE THIS ARTICLE: Dalai H, Dash SK, Panda P, et al. Clonidine versus dexmedetomidine as adjuvant to 0.5% ropivacaine in infraclavicular vertical brachial plexus block-A randomised control study. J. Evid. Based Med.