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The effects of clonidine on ropivacaine 0.75% in axillary perivascular brachial plexus block
Authors:Erlacher W  Schuschnig C  Orlicek F  Marhofer P  Koinig H  Kapral S
Institution:Department of Anesthesiology and General Intensive Care, University of Vienna, Austria.
Abstract:INTRODUCTION: The new long-acting local anesthetic ropivacaine is a chemical congener of bupivacaine and mepivacaine. The admixture of clonidine to local anesthetics in peripheral nerve block has been reported to result in a prolonged block. The aim of the present study was to evaluate the effects of clonidine added to ropivacaine on onset, duration and quality of brachial plexus block. METHODS: Patients were randomly allocated into two groups. In group I brachial plexus was performed using 40 ml of ropivacaine 0.75% plus 1 ml of NaCL 0.9%, and in group II brachial plexus was performed using 40 ml of ropivacaine 0.75% plus 1 ml (0.150 mg) of clonidine. Onset of sensory and motor block of radial, ulnar, median and musculocutaneous nerve were recorded. Motor block was evaluated by quantification of muscle force, according to a rating scale from 6 (normal contraction force) to 0 (complete paralysis). Sensory block was evaluated by testing response to a pinprick in the associated innervation areas. Finally, the duration of the sensory block was registered. Data were expressed in mean+/-SD. For statistical analysis a Student t-test was used. A P-value of < or = 0.05 was considered as statistically significant. RESULTS: The duration of blockade was without significant difference between the groups. Group I: 718+/-90 min; Group II: 727+/-117 min. There was no intergroup difference in sensory and motor onset or in quality of blockade. CONCLUSION: The addition of clonidine to ropivacaine 0.75% does not lead to any advantage of block of the brachial plexus when compared with pure ropivacaine 0.75%.
Keywords:Anesthetic techniques: regional  axillary  anesthetics  local: ropivacaine  sympathetic nervous system: clonidine
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