A Comparative Study of Efficacy of Dexmedetomidine Versus Clonidine as Adjuvant to Ropivacaine in PNS Guided Supraclavicular Brachial Plexus Block

Abstract

Background: Regional anesthesia, particularly ‘ the supraclavicular brachial plexus block, is widely used for upper limb surgeries due to its rapid onset, dense blockade, and superior postoperative analgesia. The addition of α2- adrenergic agonists as adjuvants to local anesthetics can enhance block characteristics. Aim: To compare the efficacy of dexmedetomidine and clonidine as adjuvants to ropivacaine in PNS-guided supraclavicular brachial plexus block. Methodology: This prospective comparative observational study was conducted on 80 ASA I–II patients undergoing elective upper limb surgeries. Patients were randomly assigned to two groups: RC (ropivacaine with clonidine 1 μg/kg) and RD (ropivacaine with dexmedetomidine 1 μg/kg). Onset and duration of sensory and motor blocks, duration of analgesia, and hemodynamic parameters were assessed and analyzed using SPSS v24, with p ≤ 0.05 considered significant. Results: The RD group showed a significantly faster onset of sensory (5.1 ± 0.9 vs. 10.65 ± 1.14 min) and motor block (10.23 ± 1.12 vs. 14.8 ± 1.29 min) and prolonged sensory (752.5 ± 5.9 vs. 470.25 ± 29.39 min), motor (513.75 ± 20.34 vs. 274.75 ± 28.19 min), and analgesia duration (765.82 ± 104.48 vs. 464.27 ± 66.2 min) than RC (p < 0.001). Hemodynamics remained stable in both groups. Conclusion: Dexmedetomidine is a superior adjuvant to ropivacaine compared to clonidine, providing faster onset, longer block duration, and extended analgesia without significant adverse effects.