Comparative Study of Clonidine and Dexmedetomidine as an Adjuvant with Ropivacaine in Supraclavicular Brachial Plexus Block for Upper Limb Surgery

Kanvee, Vania; Patel, Kena; Doshi, Mamta; Mayur, Vania; Kapil, Gandha

doi:10.5455/jrmds.2015327

Cited by 8 publications

(14 citation statements)

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“…Dexmedetomidine when added to ropivacaine prolongs the duration of motor blockade as compared to clonidine and fentanyl. Similar results were noted in other studies [9,10,11].…”

Section: Discussionsupporting

confidence: 93%

“…Vania Kanvee, Kena Patel [9] concluded that the efficacy of dexmedetomidine as an adjuvant to ropivacaine in supraclavicular brachial plexus block for upper limb surgery was superior to clonidine because longer duration of motor blockade than Clonidine without significant adverse effects. Vallem Balasubramanyam [10], concluded that that dexmedetomidine 1 mcg/kg as an adjuvant result early onset of motor blockade, prolonged duration of motor blockade and with better quality of block as compared to clonidine 1 mcg/kg when added to ropivacaine in supraclavicular brachial plexus block.…”

Section: Discussionmentioning

confidence: 99%

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Comparative Study for Anaesthetic Quality with the Addition of Clonidine, Fentanyl or Dexmedetomidine to 0.5℅ Ropivacaine in Supraclavicular Brachial Plexus Block at a Tertiary Hospital

Naveen¹

2021

J Clin Anesthes Res

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Background: Supraclavicular Brachial plexus block also described as the “spinal of arm”, provides a rapid onset, complete, predictable, and dense anesthesia for the mid humerus, forearm and hand surgery. Brachial plexus block also causes sympathetic block with resultant improvement in blood flow, reduction in vasospasm, and edema which is more favorable for an acute hand injury and reconstructive plastic surgery. In the present study, we compared the anesthetic quality with the addition of either clonidine, fentanyl, or dexmedetomidine to 0.5℅ ropivacaine for supraclavicular brachial plexus block in regard to the onset and duration of sensory/motor block and duration of analgesia at a tertiary hospital. Material and Methods: Present study was the prospective, interventional and comparative study carried out in the department of anaesthesiology, in patients 18-60 years, ASA grade1/2, Mallampati grades 1 and 2, posted for elective upper limb surgeries. 60 patients were randomly divided into three groups, each group includes 20 patients, (Group D- Dexmedetomidine, C- Clonidine, F- Fentanyl). Results: 60 patients scheduled to undergo elective upper limb surgeries were randomly divided into three groups (Group D, C, F), each group includes 20 patients. Age, gender, ASA status, weight, height and mean duration of surgery were comparable in three groups and the difference was statistically insignificant. The difference between the onset of sensory blockade, mean time of onset of complete sensory blockade, duration of complete sensory blockade was found to be statistically significant. Intergroup analysis in groups D, C and F for the onset of sensory blockade, onset of complete sensory blockade and duration of complete sensory blockade in three different groups noted a statistically significant difference. The difference for the onset of motor blockade, the onset of complete motor blockade and duration of motor blockade was found to be statistically significant as (p<0.05), there is a difference noted between Group D, C, and F. Intergroup statistical analysis of the onset of motor blockade, the onset of complete motor blockade and duration of motor blockade between group D vs C and group D vs F were statistically significant, whereas between group C vs F it was insignificant. The duration of analgesia was prolonged in Group D, C, F and was found to be statistically significant. Intergroup analysis of duration of analgesia between three different groups. The difference between group D vs C, between group D vs F, and between-group C vs F was statistically significant. The time of 1st rescue analgesia was prolonged in Group D, C, F and was statistically significant (p<0.05). Intergroup analysis of the time of 1st rescue analgesia between three different groups. The difference between group D vs C, between group D vs F, and between group C vs F were statistically significant. Conclusion: Dexmedetomidine, clonidine added to ropivacaine shortens the onset of sensory and motor blockade, prolongs the duration of the sensory blockade as compared to fentanyl. Dexmedetomidine shortens the onset of sensory and motor blockade much more than clonidine.

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“…Dexmedetomidine when added to ropivacaine prolongs the duration of motor blockade as compared to clonidine and fentanyl. Similar results were noted in other studies [9,10,11].…”

Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Comparative Study for Anaesthetic Quality with the Addition of Clonidine, Fentanyl or Dexmedetomidine to 0.5℅ Ropivacaine in Supraclavicular Brachial Plexus Block at a Tertiary Hospital

Naveen¹

2021

J Clin Anesthes Res

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“…45,[63][64][65]78,80 Nineteen trials compared dexmedetomidine with clonidine in 1130 patients. 31,42,[95][96][97][98][99][100][101][102][103][104][105][106][107][108][109][110][111] Different doses of adjuvants were compared in seven trials. 17,22,30,40,62,64,86 One trial tested clonidine with different local anaesthetics 25 (Table 1).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The duration of BPB was 205 min (TSA adj. 95% CI 162, 249; p < .00001; 1030 patients; 19 trials) 31,42,[95][96][97][98][99][100][101][102][103][104][105][106][107][108][109][110][111] longer for dexmedetomidine compared with clonidine (weighted mean duration in clonidine group 481 min) (Figure 4, Appendix S7 and Table 2).…”

Section: Dexmedetomidine Versus Clonidinementioning

confidence: 99%

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

Andersen

Karlsen

Geisler

et al. 2021

Acta Anaesthesiol Scand

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Background:We review the efficacy and safety of dexmedetomidine and clonidine as perineural or systemic adjuvants for brachial plexus blocks (BPB). Methods:We included randomised controlled trials on upper limb surgery with BPBs in adults, comparing dexmedetomidine with clonidine or either drug with placebo.The primary outcome was duration of analgesia. Secondary outcomes included adverse and serious adverse events. The review was conducted using Cochrane standards, trial sequential analyses (TSA) and Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results: We included 101 trials with 6248 patients. Overall, duration of analgesia was prolonged with both clonidine (176 min [TSA adj. 95% CI: 118, 205, p < .00001; 33 trials]) and dexmedetomidine (292 min [TSA adj. 95% CI: 245 329, p < .00001; 53 trials]), but was longer for dexmedetomidine than clonidine (205 min [TSA adj. 95% CI: 157, 254, p < .00001; 19 trials]). Compared with placebo, dexmedetomidine was associated with bradycardia (RR 4.2 [95% CI 2.2, 8.3]), and both clonidine (RR 4.5 [95% CI 1.1, 18.3]) and dexmedetomidine (RR 3.9 [95% CI 2.0, 7.5]) were associated with hypotension. Serious adverse events were mostly related to block technique. GRADErated quality of evidence was low or very low. Conclusion:Alpha2-receptor agonists used as adjuvants for BPBs lead to a prolonged duration of analgesia, with dexmedetomidine as the most efficient. Alpha2-receptor agonists were associated with increased risk of cardiovascular adverse events. The quality of evidence was low to very low.

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Dexmedetomidine versus clonidine as an adjuvant to local anaesthetic in brachial plexus blocks: a meta-analysis of randomised controlled trials

Bajpai

Patel²,

Dwivedi³

et al. 2023

Brazilian Journal of Anesthesiology (English Edition)

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Comparative Study of Clonidine and Dexmedetomidine as an Adjuvant with Ropivacaine in Supraclavicular Brachial Plexus Block for Upper Limb Surgery

Cited by 8 publications

References 0 publications

Comparative Study for Anaesthetic Quality with the Addition of Clonidine, Fentanyl or Dexmedetomidine to 0.5℅ Ropivacaine in Supraclavicular Brachial Plexus Block at a Tertiary Hospital

Comparative Study for Anaesthetic Quality with the Addition of Clonidine, Fentanyl or Dexmedetomidine to 0.5℅ Ropivacaine in Supraclavicular Brachial Plexus Block at a Tertiary Hospital

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

Dexmedetomidine versus clonidine as an adjuvant to local anaesthetic in brachial plexus blocks: a meta-analysis of randomised controlled trials

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Comparative Study of Clonidine and Dexmedetomidine as an Adjuvant with Ropivacaine in Supraclavicular Brachial Plexus Block for Upper Limb Surgery

Cited by 8 publications

References 0 publications

Comparative Study for Anaesthetic Quality with the Addition of Clonidine, Fentanyl or Dexmedetomidine to 0.5℅ Ropivacaine in Supraclavicular Brachial Plexus Block at a Tertiary Hospital

Comparative Study for Anaesthetic Quality with the Addition of Clonidine, Fentanyl or Dexmedetomidine to 0.5℅ Ropivacaine in Supraclavicular Brachial Plexus Block at a Tertiary Hospital

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

Dexmedetomidine versus clonidine as an adjuvant to local anaesthetic in brachial plexus blocks: a meta-analysis of randomised controlled trials

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