A comparative clinical study of injection clonidine versus midazolam in supraclavicular brachial plexus block for sedation and postoperative analgesia: a study of 60 cases.

A randomised clinical study was conducted in 60 ASA I-II patients undergoing elective upper limb orthopaedic surgeries (duration of surgery < or =120 minutes). All the patients were divided into two groups (n=30 each), group C (clonidine) and group M (midazolam). All were premedicated with injection glycopyrrolate 0.2 mg intramuscular 30 minutes before surgery and given injection bupivacaine 0.5% plain 20 ml and injection lignocaine 2% plain 10 ml in supraclavicular brachial plexus block. In group C patients injection clonidine 150 mcg and in group M injection midazolam preservative free 5 mg were administered along with local anaesthetics. All the patients were observed for onset and duration of sensory and motor blockade, sedation score, postoperative analgesia with visual analogue scale (VAS) score up to 12 hours. There was no clinically significant difference in onset and duration of sensory and motor blockade among both the study groups. Intra-operative haemodynamic monitoring with non-invasive blood pressure, pulse rate, ECG, and Sp(o2) was done. In group C more sedation (score 2) was observed compared to group M (score 1) though the data is not statistically significant. Postoperative analgesia was more prolonged in group C (VAS score < or =3 for 360 minutes) as compared to group M (VAS score < or =3 for 300 minutes), time of rescue analgesia was noticed in the form of patient demand analgesia (VAS score > or =3) and injection diclofenac 75 mg intramuscular was given. In group C 22 patients required only 1 dose while 7 patients required 2 doses and only 1 patient required 3 doses in 24 hours. In group M 5 patients required 1 dose and 23 patients required 2 doses and 2 patients required 3 doses in 24hours, though the data was not statistically significant. No complication was observed in any patient in both the groups. So injection clonidine provides better postoperative analgesia and more sedation than midazolam.