Abstract

In this study, we have compared the analgesic effect of addition of dexmedetomidine and clonidine as an adjuvant to 20 ml solution of 0.5% bupivacaine in ultrasound guided supraclavicular brachial plexus block .Dexmedetomidine is an α-2 adrenoreceptor agonist and it can prolong the motor and sensory block for local anaesthesia. It acts by binding to presynaptic C- fibre and postsynaptic dorsal horn neurons. The analgesic action is a result of depression of release of C- fiber transmitters and hyperpolarization of postsynaptic dorsal horn neurons. Methodology: Patient were randomly grouped by close-envelope technique into the three equal group of 30 in each group. Total 90 patients were including in this study. The blind nature of the study was maintained and the study drug is given according as, Group -1: 20 ml of 0.5% bupivacaine.(Control group). Group -2: 20 ml of 0.5% bupivacaine with 1mcg/kg of clonidine and. Group -3: 20 ml of 0.5% bupivacaine with 1mcg/kg dexmedetomidine for spinal anesthesia. Result: Patients in dexmedetomidine group-3 had a significantly longer sensory. Results: Patients in dexmedetomidine group-3 had a significantly longer sensory (546±32.5min) and motor block (442± 42.2min) time as compared to patients in clonidine and control group.(P<0.001). The time for first request of analgesic in the post-operative period was also longer in dexmedetomidine group (445±33.6 min) when compared to bupivacaine (control group) and clonidine group in which it was (292±18.5min) and (362±22.6 min )respectively. (P<0.001). Conclusion: We concluded that dexmedetomidine with bupivacaine for local anaesthesia is associated with more prolonged motor and sensory block than clonidine with bupivacaine and bupivacaine alone.

Description