Addition of clonidine or fentanyl with bupivacaine for supraclavicular brachial plexus blocks in upper limb surgery - a randomized comparative study

Authors

  • Nasir Uddin Ahmed Department of Anaesthesiology and Intensive Care, National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR)
  • Mozaffor Hossain Department of Anaesthesiology and ICU, Dhaka Medical Collage
  • AKM Akhtaruzzaman Department of Anaesthesia, Analgesia & Intensive Care Medicine, Bangabandhu Sheikh Mujib Medical University
  • Montosh Kumar Mondol Department of Anaesthesia, Analgesia and Intensive care Medicine, Bangabandhu Sheikh Mujib Medical University
  • UH Shahera Khatun Department of Anaesthesiology and ICU, Dhaka Medical College

DOI:

https://doi.org/10.3329/jbsa.v24i1.19792

Keywords:

Supraclavicular, clonidine, fentanyl, brachial plexus block, bupivacaine

Abstract

Background The popularity of supraclavicular brachial plexus block in upper limb surgery in recent years are due to better understanding of using adjuvant to local anaesthetics, its advantages and in avoidance of the hazards of general anaesthesia.

Objective To compare the quality of anaesthesia and duration of analgesia with clonidine-bupivacaine or fentanyl-bupivacaine in supraclavicular brachial plexus block.

Method A total number of 60 patients (ASA class 1 and II) were selected randomly into two groups, thirty in each group. Group-A (control group) received fentanyl (100ìg) 2ml and bupivacaine (0.25%) 38ml, total of 40ml.Group-B (study group) received clonidine (150ìg) 2ml and bupivacaine (0.25%) 38ml, total of 40ml.The parameters including pulse rate, non-invasive systolic and diastolic blood pressure, respiratory rate, SpO2, onset and duration of motor and sensory block, post operative pain score in VAS, duration of analgesia, first analgesic demand, side effects were assessed and recorded.

Result Onset and duration of sensory block were significantly higher in group-B than in group-A (P<0.001) and motor block were quite prolonged in group-B than group-A (p<0.001), prevalence of sedation in group-B slightly higher than group-A. But intensity of pain measured by VAS in group-A expressed highest at 8 hours of postoperative period and group-B shows highest VAS at 12 hours. Duration of effective analgesia (time from supraclavicular block to first analgesic demand) in study group-B had significantly longer mean duration than that produced by control group-A (14.4 ± 1.3 vs 10.9 ± 1.5 hours; P<0.001).

Conclusion Clonidine and bupivacaine combination is a better alternative to fentanyl and bupivacaine in respect of quality of anaesthesia and duration of analgesia.

DOI: http://dx.doi.org/10.3329/jbsa.v24i1.19792

Journal of Bangladesh Society of Anaesthesiologists 2011; 24(1): 3-7

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Published

2014-08-02

How to Cite

Ahmed, N. U., Hossain, M., Akhtaruzzaman, A., Mondol, M. K., & Khatun, U. S. (2014). Addition of clonidine or fentanyl with bupivacaine for supraclavicular brachial plexus blocks in upper limb surgery - a randomized comparative study. Journal of the Bangladesh Society of Anaesthesiologists, 24(1), 3–7. https://doi.org/10.3329/jbsa.v24i1.19792

Issue

Vol. 24 No. 1 (2011)

Section

Original Articles