Clonidine, but not Dexamethasone, Prolongs Ropivacaine-Induced Supraclavicular Brachial Plexus Nerve Block Duration

Title:Clonidine, but not Dexamethasone, Prolongs Ropivacaine-Induced Supraclavicular Brachial Plexus Nerve Block Duration

Volume: 12 Issue: 2

Author(s): Dawood Nasir*, Irina Gasanova, Shaina Drummond, John Alexander, Jo Howard, Emily Melikman, Gary Hill, Abu Minhajuddin, Babatunde Ogunnaike and Charles Whitten

Affiliation:

• Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas,United States

Keywords: Acute pain, supraclavicular nerve block, ropivacaine, dexamethasone, clonidine, adjuvant.

Abstract: Background: Ultrasound-guided supraclavicular brachial plexus block (USSB) provides excellent postoperative analgesia after upper extremity surgery. Dexamethasone and clonidine have been added to local anesthetics to enhance and prolong the duration of analgesia.

Objective: The objective of this randomized prospective study is to evaluate the efficacy of dexamethasone, clonidine, or combination of both as adjuvants to ropivacaine on the duration of USSB for postoperative analgesia.

Methods: Patients receiving USSB for postoperative pain control for upper extremity surgery were randomized to one of four groups; ropivacaine 0.5%, ropivacaine 0.5% with 4 mg dexamethasone, ropivacaine 0.5% with 100 mcg clonidine , or ropivacaine 0.5% with 4 mg dexamethasone and 100 mcg clonidine. Pain scores, sensory and motor function were evaluated at post anesthesia care unit (PACU), discharge and at 24 h postoperatively.

Results: The duration of sensory and motor blocks was significantly longer in clonidine groups when compared to ropivacaine alone [Sensorial analgesia: ropivacaine alone 13.4±6, Ropivacaine- Clonidine 17.4±6; Ropivacaine-Dexamethasone-Clonidine 18.8±6.2; Motor blocks: Ropivacaine 12±5, Ropivacaine-Clonidine 16.8±5.2, Ropivacaine-Dexamethasone-Clonidine 18.2±5.7]. In clonidine groups, there was significant prolongation of motor and sensory block when compared to ropivacaine group alone.

Conclusion: The results demonstrated that clonidine significantly prolongs the duration of ropivacaine effects for the postoperative analgesia in patient underwent upper arm surgeries.

Cite this article as:

Nasir Dawood*, Gasanova Irina, Drummond Shaina , Alexander John , Howard Jo , Melikman Emily , Hill Gary , Minhajuddin Abu , Ogunnaike Babatunde and Whitten Charles, Clonidine, but not Dexamethasone, Prolongs Ropivacaine-Induced Supraclavicular Brachial Plexus Nerve Block Duration, Current Clinical Pharmacology 2017; 12 (2) . https://dx.doi.org/10.2174/1574884712666170605085508