Supraclavicular Aprroach in Upper Limb Surgeries Using Ultrasound Guided Technique

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Supraclavicular Aprroach in Upper Limb Surgeries Using Ultrasound Guided Technique

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Photo by Daiga Ellaby on Unsplash

Photo by Daiga Ellaby on Unsplash

Why is it important?

Backgrounds and Objectives: Supraclavicular Brachial plexus block provides safe,effective,low cost anaesthesia with excellent post operative analgesia . The current study was an attempt to compare Bupivacaine 0.5% with Bupivacaine 0.5% plus Clionidine 2mcg/kg in supraclavicular brachial plexus block with respect to Onset time and Duration of Sensory blockade, Duration of Analgesia, Side effects. Materials and Methods: Present study was carried out in the Department of Anaesthesiology and critical care, MVJ Medical College and RH, Bangalore from December 2014 to July 2016. Each patient was randomly allocated to one of the two groups of 50 patients each. Bupivacaine Group (A): Receives 30ml Bupivacaine 0.5% and 1ml of normal saline Clonidine Group (B): Receives 30 ml Bupivacaine 0.5% and clonidine 2mcg/kg in 1ml saline. Parameters: The effect was studied with respect to Onset time and Duration of Sensory and Motor blockade, Duration of Analgesia and Side-effects. Results: Onset of Sensory block: In our study, we observed that onset of sensory block was earlier in Clonidine group (Group B) having a mean value 7.20±1.95 minutes in comparision with Bupivacaine group (Group A) having a mean value of 17.63±3.25 minutes which is statistically significant. Onset of Motor block: In our study, we observed that onset of Motor block was earlier in Clonidine group (Group B) having a mean value of 9.87±2.60 minutes in comparision with Bupivacaine group ( Group A) having a mean value of 20.57±2.92 minutes which is statistically significant . Duration of Sensory block : The Duration of sensory block was 359.00±60.53 minutes with Bupivacaine group (Group A) and 552.67±32.05 minutes with Clonidine group (Group B). The duration of sensory block was longer in Clonidine group compared with Bupivacaine group, which is statistically significant. Duration of Motor block: The Duration of Motor block was 390.00±55.52 minutes with Bupivacaine group (GroupA) and 597.33±27.91 minutes with Clonidine group (Group B). The duration of Motor block was longer in Clonidine group compared with Bupivaine group, which is statistically significant. Duration of Analgesia the Duration of Analgesia was minutes with 361.67±59.77 Bupivacaine group (GroupA) and 563.67±33.16 minutes with Clonidine group (Group B). The duration of Analgesia was longer in Clonidine group compared with Bupivaine group, which is statistically significant. Variations in Heart rate, Blood pressure, SpO2, Respiratory rate were statistically not significant in both the groups. No patient in our study developed any significant side effects. Conclusion: Addition of 2mcg/kg of Clonidine to Bupivacaine 0.5% has Early onset of Sensory blockade, Early onset of Motor blockade, Prolonged Duration of Sensory blockade Prolonged Duration of Motor blockade, Prolonged Duration of Analgesia when compared to Bupivacaine 0.5% at equal volumes. Both the groups maintain stable Hemodynamic profile Perioperatively and are devoid of any Side effects at the concentration and volumes used for the study.

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