Comparison Between Dexamethasone Versus Clonidine as Adjuvants to 0.75% Ropivacaine in Ultrasound Guided Brachial Plexus Block for Upper Limb Orthopedic Surgeries: A Randomized Prospective Clinical Study

Mahima K Balakrishnaiah; Karthik G Sheshadri; Sudheer Ramegowda; Rahul Srinivasan; Raghavendra Ullas Lolakrishna; Monisha T Sambandam

doi:10.18502/aacc.v10i1.14773

Mahima K Balakrishnaiah Department of Anaesthesiology, MVJ Medical College & Research Hospital, Hoskote, Karnataka, India.
Karthik G Sheshadri Department of Anaesthesiology, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India.
Sudheer Ramegowda Department of Anaesthesiology, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India.
Rahul Srinivasan Department of Anaesthesiology, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India.
Raghavendra Ullas Lolakrishna Department of Anaesthesiology, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India.
Monisha T Sambandam Department of Anaesthesiology, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India.

DOI: https://doi.org/10.18502/aacc.v10i1.14773

Keywords: Brachial plexus block; Ultrasound; Ropivacaine; Dexamethasone; Clonidine

Abstract

Background: Ropivacaine is an amino-amide local anesthetic, extensively used for peripheral nerve blocks, numerous adjuvants have been added to Ropivacaine to prolong the duration of analgesia. Aim: To compare the effectiveness of adding Dexamethasone to Ropivacaine versus adding Clonidine to Ropivacaine in ultrasound guided supraclavicular brachial plexus block in terms of analgesic duration, onset & duration of sensory and motor blockade.

Methods: A prospective randomized single blinded study carried out in 70 patients of ASA grade I and II, aged 20 to 60 years scheduled for elective upper limb orthopedic surgeries. Patients were randomly allocated into two groups, Group RC - patients received 20ml of 0.75% ropivacaine along with 1mcg/kg of clonidine diluted to 2ml of normal saline, Group RD - patients received 20ml of 0.75% ropivacaine along with 8mg of dexamethasone (2ml). Statistical Analysis: Onset & duration of sensorimotor blockade, duration of analgesia was assessed by Unpaired t-test. If p-value <0.05, results were statistically significant & p-value <0.001 were highly significant.

Results: Duration of analgesia is superior and statistically significant in Group RD (1,172.57± 18.37 vs 931.09± 16.3). Onset time for sensory (3.14 ± 1.00 vs 9.71± 1.23) and motor (7.60 ± 1.54 vs 13.66± 1.03) block is rapid in Group RD. Duration of sensory (1,106.57± 20.28 vs 786.26± 31.43) and motor (997.74 ± 24.9 vs 674.57 ± 2.18) block is enhanced in Group RD.

Conclusion: Dexamethasone as an adjuvant to ropivacaine provided superior post-operative analgesia, faster onset and longer duration of sensory and motor blockade.