Ali Qazi Ehsan, Manjunatha L, Amir Syed Hussain, Jamil Shaista, Quadir Abdul
Department of Anaesthesiology, Jawaharlal Nehru Medical College, A.M.U, Aligarh, Uttar Pradesh, India.
Indian J Anaesth. 2014 Nov-Dec;58(6):709-13. doi: 10.4103/0019-5049.147150.
Bupivacaine has been the most frequently used local anaesthetic in brachial plexus block, but ropivacaine has also been successfully tried in the recent past. It is less cardiotoxic, less arrhythmogenic, less toxic to the central nervous system than bupivacaine, and it has intrinsic vasoconstrictor property. The effects of clonidine have been studied in peripheral nerve blockade. The purpose of this study was to evaluate the effects of clonidine on nerve blockade during brachial plexus block with ropivacaine using peripheral nerve stimulator.
Sixty patients were randomly divided into two groups, Group A and B. Group A received 30 ml of 0.5% of ropivacaine with 0.5 ml normal saline while Group B received same amount of ropivacaine with 0.5 ml (equivalent to 75 μg) of clonidine for supraclavicular brachial plexus block. The groups were compared regarding quality of sensory and motor blockade, duration of post-operative analgesia and intra and post-operative complications.
There was a significant increase in duration of motor and sensory block and analgesia in Group B as compared to Group A patients (P < 0.0001). There was no significant difference in onset time in either group (P = 0.304). No significant side effects were noted.
The addition of 75 μg of clonidine to ropivacaine for brachial plexus block prolongs motor and sensory block and analgesia without significant side effects.
布比卡因一直是臂丛神经阻滞中最常用的局部麻醉药,但罗哌卡因在最近也已成功应用。与布比卡因相比,它的心脏毒性较小,致心律失常作用较小,对中枢神经系统毒性较小,并且具有内在的血管收缩特性。可乐定在周围神经阻滞中的作用已得到研究。本研究的目的是使用外周神经刺激器评估可乐定在罗哌卡因臂丛神经阻滞期间对神经阻滞的影响。
60例患者随机分为A组和B组。A组接受30毫升0.5%罗哌卡因加0.5毫升生理盐水,而B组接受等量罗哌卡因加0.5毫升(相当于75微克)可乐定用于锁骨上臂丛神经阻滞。比较两组在感觉和运动阻滞质量、术后镇痛持续时间以及术中和术后并发症方面的情况。
与A组患者相比,B组患者的运动和感觉阻滞及镇痛持续时间显著延长(P < 0.0001)。两组的起效时间无显著差异(P = 0.304)。未观察到显著的副作用。
在罗哌卡因中添加75微克可乐定用于臂丛神经阻滞可延长运动和感觉阻滞及镇痛时间,且无显著副作用。