ASSESSMENT OF ANALGESIC EFFICACY OF CLONIDINE AND FENTANYL WITH ROPIVACAINE IN THE SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK

Abstract

Ropivacaine, the S (-) enantiomer of N-(2,6- dimethylphenyl)-1-propyl-2-piperidinecarboxamide is a new long-acting local anesthetic like bupivacaine. Ropivacaine, compared to bupivacaine blocks pain transmitting A-delta and C fibers to a greater extent than A-beta fibers (controlling motor function). Ropivacaine has a wider margin of safety and is less cardiac & neurotoxic compared to bupivacaine with similar duration of action. The fentanyl and clonidine given with local anaesthetic in regional nerve block enhances the block by acting perineurally or it is because of systemic absorption of fentanyl and clonidine administered in block. The current study was planned to compare the efficacy of fentanyl and clonidine as an adjuvants and as an intravenous administration in supraclavicular plexus block with 0.75% ropivacaine.

The study was planned in the Department of the Surgery undergoing the Anaesthesia in  Sri  Krishna  Medical  College  and  Hospital,  Muzaffarpur, from Jan 2017 to Jun 2017. After obtaining proper informed consent, 40 adult patients of both sexes, aged 18 to 65 years, belonging to ASA I or II and undergoing supraclavicular brachial plexus block were enrolled for this study.

The data from the [resent study concludes that the arliest onset of sensory and motor blockade as well as longer duration of analgesia resulted when clonidine 150 µg was used as a perineural adjuvant to Ropivacane 0.75% with minimal side effects compared to its same dose given intravenously.

Keywords: supraclavicular  block, clonidine, fentanyl , ropivacaine, etc.