Abstract
Adding adjuvants to local anesthetics in nerve blocks improves the onset, duration, and quality of anesthesia. This prospective, comparative study evaluated the effects of bupivacaine (0.5%) combined with either dexamethasone or clonidine in upper limb blocks, focusing on analgesia duration, block characteristics, and side effects. Forty patients undergoing upper limb surgeries were randomly assigned to two groups: Group D (n=20) received bupivacaine with dexamethasone, and Group C (n=20) received bupivacaine with clonidine. Parameters assessed included sensory and motor block onset and duration, analgesia duration, block quality, and adverse effects. Statistical analysis was done using independent t-tests and chi-square tests, with p<0.05 considered significant. Group D showed a faster sensory block onset (5.4 ± 1.2 min) than Group C (6.1 ± 1.4 min, p=0.03), with no significant difference in motor block onset (p=0.08). Sensory and motor block durations were significantly longer in Group D (840 ± 105 min and 720 ± 96 min) than in Group C (630 ± 90 min and 560 ± 88 min), p<0.001. Analgesia lasted longer in Group D (960 ± 108 min) compared to Group C (690 ± 100 min), p<0.001. Superior block quality was reported in Group D (24 vs. 17 patients, p=0.03). Sedation occurred more in Group C (5 cases vs. 0; p=0.02), with no significant differences in other adverse effects. Bupivacaine with dexamethasone is superior to bupivacaine with clonidine for upper limb blocks, offering improved block characteristics and fewer side effects.
Keywords: Bupivacaine, Clonidine, Dexamethasone, Upper Limb Block.