comparison between dexamethasone versus clonidine as adjuvants to 0.75% ropivacaine in ultrasound guided brachial plexus block for upper limb orthopedic surgeries: a randomized prospective clinical study

Background: ropivacaine is an amino-amide local anesthetic, extensively used for peripheral nerve blocks, numerous adjuvants have been added to ropivacaine to prolong the duration of analgesia. aim: to compare the effectiveness of adding dexamethasone to ropivacaine versus adding clonidine to ropivacaine in ultrasound guided supraclavicular brachial plexus block in terms of analgesic duration, onset & duration of sensory and motor blockade.methods: a prospective randomized single blinded study carried out in 70 patients of asa grade i and ii, aged 20 to 60 years scheduled for elective upper limb orthopedic surgeries. patients were randomly allocated into two groups, group rc - patients received 20ml of 0.75% ropivacaine along with 1mcg/kg of clonidine diluted to 2ml of normal saline, group rd - patients received 20ml of 0.75% ropivacaine along with 8mg of dexamethasone (2ml). statistical analysis: onset & duration of sensorimotor blockade, duration of analgesia was assessed by unpaired t-test. if p-value <0.05, results were statistically significant & p-value <0.001 were highly significant.results: duration of analgesia is superior and statistically significant in group rd (1,172.57± 18.37 vs 931.09± 16.3). onset time for sensory (3.14 ± 1.00 vs 9.71± 1.23) and motor (7.60 ± 1.54 vs 13.66± 1.03) block is rapid in group rd. duration of sensory (1,106.57± 20.28 vs 786.26± 31.43) and motor (997.74 ± 24.9 vs 674.57 ± 2.18) block is enhanced in group rd.conclusion: dexamethasone as an adjuvant to ropivacaine provided superior post-operative analgesia, faster onset and longer duration of sensory and motor blockade.