Comparative efficacy of dexmedetomidine vs. clonidine as an adjuvants to 0.5% ropivacaine for supraclavicular block in upper extremities surgery
Abstract
Background & objective: Supraclavicular brachial plexus block (SCBPB) is a cornerstone for upper limb surgeries, providing adequate regional anaesthesia with minimal systemic involvement. Ultrasound guidance enhances its precision and safety. While ropivacaine is a commonly used local anaesthetic, its efficacy can be augmented with adjuvants such as dexmedetomidine and clonidine, which have shown promise in enhancing block characteristics.
We compare the efficacy of dexmedetomidine and clonidine as adjuvants to 0.5% ropivacaine in ultrasound-guided SCBPB for elective upper limb surgeries.
Methodology: In this prospective, randomized, double-masked study, 60 ASA I/II patients aged 18–60 were assigned to two groups (n = 30 each). Group RD received ropivacaine with dexmedetomidine (0.5 mcg/kg), and Group RC received ropivacaine with clonidine (0.5 mcg/kg). Parameters included onset and duration of sensory and motor block, time to first analgesia, VAS score, hemodynamic trends, and adverse effects.
Results: Group RD exhibited significantly faster onset and longer sensory and motor block duration than Group RC (p < 0.05). Time to first rescue analgesia was significantly longer in Group RD (720.5 ± 45.3 min) than in Group RC (580.2 ± 38.6 min; p < 0.0001). VAS scores were consistently lower in Group RD at 2, 6, and 12 hours postoperatively. Hemodynamic parameters remained stable in both groups. The incidence of adverse effects was low and comparable between groups.
Conclusion: Dexmedetomidine, as an adjuvant to ropivacaine in ultrasound-guided SCBPB, provides superior block characteristics and prolonged analgesia compared to clonidine, without compromising hemodynamic stability.
Keywords: Supraclavicular brachial plexus block, ultrasound-guided regional anaesthesia, dexmedetomidine, clonidine, ropivacaine, adjuvants, postoperative analgesia, upper limb surgery.
Citation: Kor SS, Rana D, Saxena R. Comparative efficacy of dexmedetomidine vs. clonidine as an adjuvants to 0.5% ropivacaine for supraclavicular block in upper extremities surgery. Anaesth. pain intensive care 455-460. DOI: 32092026;30(4):3209
Received: July 01, 2025; Revised: September 05, 2025; Accepted: March 03, 2026
