Abstract   Background: Brachial plexus block is the ideal anaesthetic technique for upper limb surgeries. Several clinical studies have shown that Clonidine when used as an adjuvant to bupivacaine prolongs sensory and motor blockade. Aims and Objectives: To evaluate the effect of this combination of drugs with respect to the onset, duration of sensory and motor blockade and duration of analgesia in Infra-clavicular brachial plexus block for elective upper limb orthopedic surgeries. Material and Methods: In this prospective, randomized double-blind placebo controlled study, 40 patients of American Society of Anaesthesiologists Grade I or II undergoing elective upper limb orthopedic procedures through Infra-clavicular approach for brachial plexus block were randomly divided into two groups. Group C received 30ml of 0.375% Bupivacaine and 0.4ml normal saline (n=20) Group S received 30ml of 0.375% Bupivacaine and (60µg) clonidine (n=20). Both the groups were compared for onset and duration of sensory and motor block, postoperative analgesia, level of sedation, side‑effects and complications. Results: Analgesia duration was 753.2±109.6 min (mean ± standard deviation) in group S (clonidine) compared to 210.2±32.min in group C (control). Onset time was shorter while duration of sensory and motor blockade were longer in group S(clonidine) than group C(control) and the difference was statistically significant. No clinical significance was observed in hemodynamics. Ramsay Sedation Score (RSS) was higher in the group S(clonidine) group. Conclusion: Addition of small dose of clonidine (60μg) to bupivacaine shortens the onset time and prolongs the duration of sensory and motor blockade and duration of post operative analgesia significantly without any major side effects other than sedation which is beneficial in clinical practice.

Keywords: Clonidine, Bupivacaine, Infraclavicular brachial plexus block, Duration of analgesia, Randomized controlled trial, Ramsay sedation score.