Comparative evaluation of Ropivacaine hydrochloride 0.75% and ropivacaine hydrochloride 0.75% with clonidine in interscalene brachial plexus for orthopaedic upper limb surgery

Abstract

Certain adjuvants have been tried with local anaesthetics to enhance analgesic efficacy and extend the analgesic period post operatively. This randomized prospective double blind trial was designed to compare the effects of addition of clonidine to ropivacaine in interscalane brachial plexus block for upper limb surgery. Patients and methods: 60 patients of age group 20-65 years of either sex, admitted to undergo upper limb surgeries were included. Group A-Patients receiving 30ml of 0.75% ropivacaine hydrochloride plus 1ml normal saline. Group B-Patients receiving 30ml of 0.75% ropivacaine hydrochloride plus 150mcg clonidine (1ml). Results: The total duration of sensory block in group A was 7.61 + 1.62 hours while in group B was 11.62 + 1.84 hours. Total duration of motor block in group A was 5.95 + 1.38 hours while in group B was 9.82 + 1.98 hours. Duration of post-operative analgesia in group A it was 7.24 + 1.36 hours and in group B it was 11.83 + 2.33 hours. Haemodynamically both groups were stable perioperatively. Patient satisfaction score was better in group B. Conclusion: In conclusion, clonidine added to ropivacaine is an attractive option for improving the quality and duration of interscalene brachial plexus block in upper limb surgeries with stable perioperative hemodynamics.

The effect of adjuvants added to local anaesthetics for single-injection upper extremity peripheral regional anaesthesia

“…In 161 studies, patients received a supraclavicular brachial plexus block, 26,29–160 in 40 studies, patients received an axillary brachial plexus block, 24,27,161–198 in 28 studies, an interscalene block was performed, 25,199–220 in 11 studies, patients received an infraclavicular brachial plexus block, 221–231 one study used a coracoid approach to brachial plexus block 232 and one study used a suprascapular combined with axillary nerve block 233 . A detailed description of included studies is presented in the supplemental content (supplemental table 3, http://links.lww.com/EJA/A839).…”

Alpha2‐receptor agonists as adjuvants for brachial plexus nerve blocks—A systematic review with meta‐analyses

“…) [12][13][14][15][16][17]19,20,22,23,[25][26][27][28]30,31,[33][34][35][36][37][38][39][40][41][42][43] No difference was found for low-versus high-dose dexmedetomidine (p for interaction =.97) (Appendix S11).…”

“…The duration of motor nerve block was prolonged by 137 min (95% CI 117, 157, p < .00001; 22 trials) 12,[15][16][17]19,20,22,23,[25][26][27][31][32][33][34][35][36][37][38][41][42][43] with perineural clonidine. Subgroup analyses revealed no difference for lowversus high-dose clonidine (p for interaction = .50) (Appendix S13).…”