Comparison of buprenorphine and clonidine when added to bupivacaine during supraclavicular brachial plexus block

Joseph NS, Muthaiyan K, Krishnan S, Venkatesan B, Shankar R

Pdf Page Numbers :- 20-26

Nisha Saral Joseph¹, Kavitha Muthaiyan^1,*, Sureshbabu Krishnan¹, Balakrishnan Venkatesan¹ and Shankar R²

¹Department of Anaesthesia, Government Mohan Kumara Mangalam Medical College Hospital Salem, Tamil Nadu 636002, India

²Department of Preventive Medicine, Vinayaka Missions Kirupananda Variyar Medical College and Hospital, Salem, Tamil Nadu 636308, India

*Corresponding author: Dr. Kavitha Muthaiyan, Assistant Professor, Department of Anaesthesia, Government Mohan Kumara Mangalam Medical College Hospital Salem, Tamil Nadu 636002, India. Email: kavithaswaminathan.muthaiyan@gmail.com

Received 1 October 2024; Revised 21 November 2024; Accepted 29 November 2024; Published 9 December 2024

Citation: Joseph NS, Muthaiyan K, Krishnan S, Venkatesan B, Shankar R. Comparison of buprenorphine and clonidine when added to bupivacaine during supraclavicular brachial plexus block. J Med Sci Res. 2025; 13(1):20-26. DOI: http://dx.doi.org/10.17727/JMSR.2024/13-4

Copyright: © 2025 Joseph NS et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Background: During spinal and epidural anesthesia adding buprenorphine or clonidine as an adjuvant along with local anesthetic agent has given promising results in producing analgesia, whereas the same agent when used for brachial plexus block had shown mixed results. The study aimed to compare the anesthetic and analgesic properties of buprenorphine and clonidine when used as adjuvants along with bupivacaine during supraclavicular brachial plexus blockade.

Methodology: A double blinded randomized controlled trial was conducted for a period of one year. A total of 90 subjects were divided into three groups. All three groups patients received 0.3% bupivacaine as the anesthertic agent, the adjuvant used for group A patients was 1 ml normal saline, group B it was 1 ml of 300 mcg buprenorphine and group C patients received 1 ml of 150 mcg clonidine as adjuvant. Hemodynamic parameters, sensory and motor blockade levels along with the occurrence of adverse events were monitored at regular intervals among all the study subjects.

Results: Hemodynamic parameters were well maintained in all three groups without showing significant differences in the parameters. Patients in the buprenorphine group had an early onset of sensory block along with prolonged duration of block, whereas no significant changes reported with relation to motor block. As such there was no incidence of adverse events in any of the three groups.

Conclusion: Compared to clonidine, buprenorphine was found to be a better adjuvant to bupivacaine for producing analgesic effect.

Keywords: brachial plexus block; buprenorphine; clonidine; sensory; motor block