Comparative Evaluation of Post-operative Analgesia Using Visual Analogue Score (VAS) With a Low Dose of Clonidine (0.5 mcg/kg) as an Adjuvant to 0.2% Ropivacaine in Ultrasound-Guided Supraclavicular Block in Upper Limb Surgeries

TL;DR

Adding a low dose of clonidine to ropivacaine in nerve blocks for arm surgery significantly improves pain relief and lasts longer without major side effects.

Contribution

Demonstrates that low-dose clonidine enhances post-operative analgesia when combined with ropivacaine in ultrasound-guided blocks.

Findings

Clonidine extended analgesia duration to 14.33 hours compared to 6.96 hours without it.

Pain scores were significantly lower at 6 and 12 hours in the clonidine group.

No significant adverse effects were observed with clonidine use.

Abstract

Background

Effective pain management during and after surgery is essential for improving patient outcomes. Adding adjuvants like clonidine to local anesthetics enhances block efficacy and improves post-operative analgesia.

Objective

To evaluate the efficacy and safety of adding low-dose clonidine (0.5 mcg/kg) to 0.2% ropivacaine in ultrasound-guided supraclavicular brachial plexus block for upper limb surgeries by assessing the duration of postoperative analgesia, pain intensity, time to first pain complaint, time to requirement of rescue analgesia, and the influence of demographic variables (age and gender) on analgesic efficacy and duration.

Methods

A prospective observational study included 90 patients undergoing upper limb surgery. Group A (n=45) received ropivacaine, while Group B (n=45) received the same with clonidine. Pain was assessed using the Visual Analog Scale (VAS) at 0, 6, 12, and 24-48 hours postoperatively. Primary outcomes were the duration of analgesia, time to the first pain complaint, and VAS scores. Statistical analysis was done using SPSS, version 29 (p<0.05).

Results

Group B showed a significantly longer duration of analgesia (14.33±0.91 hours) compared to Group A (6.96±1.13 hours, p<0.001). VAS scores at 6 and 12 hours were significantly lower in Group B (p<0.001). No significant adverse effects were noted.

Conclusion

Adding clonidine to ropivacaine in supraclavicular brachial plexus blocks significantly prolongs analgesia and reduces pain scores without notable side effects, demonstrating it as an effective strategy for improving patient comfort.

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