Addition of clonidine or lignocaine to ropivacaine for supraclavicular brachial plexus block: a comparative study

Rohan, Bhatia; Singh, Payal Yashwant; Khurana, Gurjeet

doi:10.11622/smedj.2014057

Cited by 4 publications

(8 citation statements)

References 27 publications

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“…The systemic adverse events observed in other studies range from no side effects [ 3 , 5 , 14 , 30 ] to mild sedation [ 20 ] lower heart rate [ 2 , 20 , 35 ] and lower blood pressure [ 2 , 20 ], and are consistent with our results. These hemodynamic changes are primarily observed during the first four hours.…”

Section: Discussionsupporting

confidence: 93%

“…Results from these trials are conflicting. Four of the trials found no prolongation of the sensory nerve block supporting that clonidine has no effect at all [ 4 , 5 , 24 , 25 ], whereas others found a prolonging effect of adding clonidine to ropivacaine [ 1 – 3 , 14 , 20 – 23 ]. This effect could be caused by a peripheral mechanism of clonidine, or the absorption and systemic redistribution of the perineurally administered clonidine exerting its properties systemically.…”

Section: Discussionmentioning

confidence: 99%

“…The efficacy of clonidine used as an adjuvant to ropivacaine remains controversial. Some trials report a prolongation in the duration of nerve block [ 1 – 3 ], whereas others do not [ 4 – 6 ]. In-vitro animal studies have demonstrated a perineural effect of block prolongation, mediated through a direct inhibition of the I h current in C-fibers [ 7 ], but clonidine also possess systemic analgesic properties.…”

Section: Introductionmentioning

confidence: 99%

“…A number of studies have shown an increase in postoperative sensory block duration [ 1 – 3 , 14 ] and improved postoperative analgesia [ 13 ], when adding clonidine to ropivacaine. However, these studies did not control for systemic effects, and whether the difference in duration is caused by local effects, or by a systemic uptake of the peripherally administered clonidine remains unknown.…”

Section: Introductionmentioning

confidence: 99%

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Clonidine used as a perineural adjuvant to ropivacaine, does not prolong the duration of sensory block when controlling for systemic effects: A paired, blinded, randomized trial in healthy volunteers

et al. 2017

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BackgroundClonidine used as an adjuvant to ropivacaine have been shown to prolong the duration of peripheral nerve blocks. The mechanism of action remains unclear. We hypothesized, that clonidine used as an adjuvant to ropivacaine extends the duration of an adductor canal block (ACB) by a peripheral mechanism, compared to ropivacaine alone when controlling for systemic effects.MethodsWe conducted a paired, blinded, randomized trial in healthy volunteers. Participants received bilateral ACBs containing 20 ml ropivacaine 0.5% + 1 ml clonidine 150μg/ml in one leg and 20 ml ropivacaine 0.5% + 1 ml saline in the other leg. The primary outcome measure was duration of sensory block assessed by temperature sensation (alcohol swab). Secondary outcome measures were duration of sensory block assessed by: pinprick, maximum pain during tonic heat stimulation, warmth detection threshold and heat pain detection threshold.ResultsWe enrolled 21 volunteers and all completed the trial. There was no difference in duration of sensory block assessed with an alcohol swab: Mean duration in the leg receiving ropivacaine + clonidine was 19.4h (SD 2.7) compared to 19.3h (SD 2.4) in the leg receiving ropivacaine + placebo with a mean difference of 0.1h (95% CI: -1.0 to 1.3), P = 0.83. No differences in block duration were detected when assessed by: Pinprick, mean difference 0.0 h (95% CI: -1.3 to 1.3), maximum pain during tonic heat stimulation, mean difference -0.7 h (95% CI: -2.1 to 0.8), warmth detection threshold, mean difference -0.1 h (95% CI: -1.8 to 1.6) or heat pain detection threshold, mean difference -0.2 h (95% CI: -1.7 to 1.4).ConclusionsAdministering clonidine perineurally as an adjuvant to ropivacaine in an ACB did not prolong the duration of sensory block in a setup controlling for systemic effects of clonidine.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Clonidine used as a perineural adjuvant to ropivacaine, does not prolong the duration of sensory block when controlling for systemic effects: A paired, blinded, randomized trial in healthy volunteers

et al. 2017

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“…Group R received a single injection of the RLB with 30 mL of local anesthetic mixture (0.75% ropivacaine 20 mL + 2% lidocaine 10 mL) and IV-PCA. We planned to use a mixture of ropivacaine and lidocaine to reduce the onset time of the RLB without reducing postoperative analgesia duration [ 15 , 16 ].…”

Section: Methodsmentioning

confidence: 99%

The analgesic efficacy of a single injection of ultrasound-guided retrolaminar paravertebral block for breast surgery: a prospective, randomized, double-blinded study

et al. 2020

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Background: The thoracic paravertebral block is an effective analgesic technique for postoperative pain management after breast surgery. The ultrasound-guided retrolaminar block (RLB) is a safer alternative to conventional paravertebral block. Thus, we assessed the analgesic efficacy of ultrasound-guided RLB for postoperative pain management after breast surgery. Methods: Patients requiring breast surgery were randomly allocated to group C (retrolaminar injection with saline) and group R (RLB with local anesthetic mixture). The RLB was performed at the level of T3 with local anesthetic mixture (0.75% ropivacaine 20 mL + 2% lidocaine 10 mL) under general anesthesia before the skin incision. The primary outcome was cumulative morphine consumption using intravenous patient-controlled analgesia (IV-PCA) at 24 hour postoperatively. The secondary outcomes were the visual analogue scale (VAS) scores at 1, 6, 24, and 48 hour postoperatively and the occurrence of adverse events and patient satisfaction after the surgery. Results: Forty-six patients were included, 24 in group C and 22 in group R. The cumulative morphine consumption using IV-PCA did not differ between the two groups (P = 0.631). The intraoperative use of remifentanil was higher in group C than in group R (P = 0.025). The resting and coughing VAS scores at 1 hour postoperatively were higher in group R than in group C (P = 0.011, P = 0.004). The incidence of adverse events and patient satisfaction was not significantly different between the two groups. Conclusions: A single injection of ultrasound-guided RLB did not reduce postoperative analgesic requirements following breast surgery.

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Evaluation of Anaesthetic Efficacy of Ropivacaine for the Removal of Impacted 3rd Molars- A Randomised Control Study

2023

JODH

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This study involved 20 healthy patients (ASA 1) with bilaterally impacted mandibular third molar were randomly selected of both Sexes between age group of 20-40 years. Purpose: This study was done to evaluate the efficacy of Ropivacaine in comparison with Lignocaine for mandibular anaesthesia for bilaterally impacted mandibular third molars in aspect of onset, duration of anaesthesia, analgesia and postoperative requirement of analgesics. Method: Patients received 2ml of 2% Lignocaine with adrenaline on one side and 2ml of 0.75 % plain ropivacaine on the other side at two different appointments. Pain experiences were measured by Visual Analogue Scale (VAS) and Verbal Rating Scale (VRS). Results: In ropivacaine group, the means of onset of anesthesia, duration of anaesthesia, duration of post-operative analgesia and requirement of post-operative analgesics were 5.8±2.33 min, 533.3±142.2 min, 539.6±114.7 min and 4.2±0.8 no’s respectively and there was a significant difference between these group (<0.001). Conclusion: The efficacy of plain ropivacaine 0.75% is superior to 2% lignocaine with adrenaline 1:1,00,000 in terms of duration of anaesthesia and analgesia, intraoperative and post-operative pain control but the onset of action of plain ropivacaine is slightly higher. We conclude that Plain Ropivacaine 0.75% can be used as an alternative to lignocaine in third molar surgeries and other minor surgical procedures which necessitates longer duration of anaesthesia and analgesia in oral and maxillofacial region.

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Addition of clonidine or lignocaine to ropivacaine for supraclavicular brachial plexus block: a comparative study

Abstract: CONClUSION 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.

Cited by 4 publications

References 27 publications

Clonidine used as a perineural adjuvant to ropivacaine, does not prolong the duration of sensory block when controlling for systemic effects: A paired, blinded, randomized trial in healthy volunteers

Clonidine used as a perineural adjuvant to ropivacaine, does not prolong the duration of sensory block when controlling for systemic effects: A paired, blinded, randomized trial in healthy volunteers

The analgesic efficacy of a single injection of ultrasound-guided retrolaminar paravertebral block for breast surgery: a prospective, randomized, double-blinded study

Evaluation of Anaesthetic Efficacy of Ropivacaine for the Removal of Impacted 3rd Molars- A Randomised Control Study

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