A Clinical Study Comparing Epinephrine 200μg or Clonidine 90μg as Adjuvants to Local Anaesthetic Agent in Brachial Plexus Block Via Supraclavicular Approach

BACKGROUND: A double blind randomized prospective study was undertaken to determine the effect of adjuncts like epinephrine 200μg or clonidine 90μg in combination of bupivacaine and lignocaine into the brachial plexus sheath to study the sensory and motor onset, duration of analgesia, hemodynamic changes and adverse effects. PATIENTS & METHODS: 60 patients aged 18-65 years, with ASA grade I and II were randomly divided into group I and group II to receive 10 ml of lignocaine2% and 20 ml of bupivacaine0.5% with 1ml of 200μg epinephrine or 90μg clonidine respectively. Onset of sensory blockade was determined by pinprick method by a three point score and motor blockade by three point scale. Duration of postoperative analgesia, the hemodynamic changes, sedation scores and any adverse effects were observed. Statistical analysis was done by student's “t” test and p<0.05 was considered significant. RESULTS: It was found that there was faster onset of sensory and motor blockade, the postoperative analgesia was prolonged and the amount of sedation was profound in group II as compared to group I. All the above findings were statistically significant. CONCLUSION: We thereby conclude that clonidine 90μg is a better option as an additive than epinephrine 200μg for hastening the onset of sensory and motor block with prolonged postoperative analgesia and sedation as the only adverse effect.