A prospective, randomized, double blind, systemic controlled trial to compare analgesic efficacy of clonidine and fentanyl in supraclavicular block with 0.75% ropivacaine

Introduction and Object: Fentanyl and clonidine mostly used as adjuvant to improve quality and duration of nerve block. In present study we compared clonidine and fentanyl perineurally and systemically in Supraclavicular Brachial plexus block. Materials and Methods: Sixty eight patients were randomly assigned into four equal groups, scheduled for upper limb surgery. They received the drugs in Supraclavicular block and intravenous route as below: Group A: 24 ml 0.75% ropivacaine + 1 ml fentanyl (50µg/ml) + 5ml normal saline in block and 1ml normal saline intravenously. Group B: 24 ml 0.75% ropivacaine + 6ml normal saline in block, and 1ml fentanyl (50µg /ml) intravenously. Group C: 24 ml 0.75% ropivacaine + 1ml clonidine (150µg/ml) + 5ml normal saline in block, and 1ml normal saline intravenously. Group D: 24ml 0.75% ropivacaine +6ml normal saline in block, and 1ml clonidine (150µg/ml) intravenously. Results: Onset of sensory and motor block was significantly earlier in Group C (12.47±2.57 min & 18.00±3.46 min) than in Group A (14.65±3.41 min & 19.94±2.61 min) respectively (p<0>0.05) between Group A (7.41±0.94hrs) and Group B (7.35±0.93hrs) while it was prolonged in Group C (8.94±0.97 hrs) than Group D (8.12±1.22 hrs) (p<0> Conclusion: Fentanyl perineurally or systemically administered have comparable results while perineural clonidine offered prolonged duration of analgesia better than when it was used intravenously suggesting its local action.