• Preeti Kumari, Raj Bahadur Singh, Kumar Saurabh, Shilpi Pal, Ganesh Kumar Ram, and Rakesh Kumar Anand.
• Department of Anaesthesiology (Trauma and Emergency), Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India.
• Anesth Essays Res. 2020 Oct 1; 14 (4): 644-652.

ContextThe supraclavicular brachial plexus block is a very safe, useful and effective method for upper limb surgeries. Among local anesthetics, ropivacaine has special applications in neuraxial and peripheral nerve blocks due to its low cardiotoxicity and less toxicity to central nervous systems compared to bupivacaine and lignocaine. Dexmedetomidine is a newer and potent alpha-2 receptor agonist which has 10 times higher selectivity for alpha-2 receptors as compared to clonidine, So far, very few studies have been undertaken to compare the efficacy of clonidine and dexmedetomidine to provide and prolong postoperative analgesia, especially with the use of ultrasound for nerve localization.AimsTo compare the efficacy of postoperative analgesia between clonidine and dexmedetomidine as adjuvants with 0.5% ropivacaine by ultrasound-guided supraclavicular brachial plexus block for upper limb surgeries.Settings And DesignProspective, randomised, double-blind interventional study.Subjects And MethodsEighty patients of ASA grade I or II undergoing elective upper limb surgery were randomly divided into two groups:- Group RC (n = 40) received 35 ml of 0.5% ropivacine with 1 μg.kg-1 of clonidine. Group RD (n = 40) received 35 ml of 0.5% ropivacaine with 1 μg.kg-1 of dexmedetomidine.Statistical Analysis UsedThe statistical software SPSS version 20 has been used for the analysis. By using Pearson's Chi-Square test for Independence of Attributes/Fisher's Exact. Continuous variables were expressed as Mean, Median, and Standard Deviation and compared across the groups using unpaired t-test.ResultsIn our comparative study, dexmedetomidine 1 μg.kg-1 with 35 ml of 0.5% ropivacaine provided significantly longer duration of postoperative analgesia and earlier sensory block as compared to clonidine 1 μg.kg-1 with same dose of ropivacaine in ultrasound-guided supraclavicular brachial plexus block.ConclusionsThe ropivacaine-dexmedetomidine group in our study provided earlier sensory block and more prolonged postoperative analgesia as compared to ropivacaine-clonidine group. Thus ropivacaine-dexmedetomidine combination may be effectively used in all painful upper limb surgeries specially orthopaedic procedures.Copyright: © 2021 Anesthesia: Essays and Researches.

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