COMPARISON OF BLOCK CHARACTERISTICS OF SUBARACHNOID HYPERBARIC BUPIVACAINE WITH AND WITHOUT CLONIDINE IN LOWER LIMB SURGERIES

Dr Amit Kumar, Dr Ashok Kumar

Abstract


Introduction: Many studies are there using adjuvants such as Neostigmine, clonidine and opioids with bupivacaine in subarachnoid block for
comparing efficacy and block characteristics. However, literature is divided regarding efficacy of these intrathecal adjuvants. Furthermore, these
adjuvants have their own side effects. Hence, search for better adjuvant to bupivacaine goes on.
Aim: The aim of the present study was to evaluate the effect of intrathecal clonidine as adjuvant to bupivacaine in the subarachnoid block for lower
limb surgeries.
Materials and Methods: It was a double blinded randomized controlled study in which sixty patients posted for lower limb surgeries were divided
into two groups of thirty each. Group C – Received intrathecal hyperbaric bupivacaine (2.5 ml) +75 μg clonidine (0.5 ml). Group S – Received
intrathecal hyperbaric bupivacaine (2.5 ml) +0.5 ml normal saline. Sensory and motor block characteristics, duration of postoperative analgesia,
hemodynamic alterations and side effects were recorded and analyzed.
Result: Onset of sensory block was achieved earlier and duration of sensory & motor block was significantly prolonged in Group C compared to
Group S (P < 0.001).Time for first dose of rescue analgesic was delayed in Group C (342.33 ± 88.12 min) in comparison to Group S (191± 22.94
min) which was statistically significant (P < 0.001). There was a fall in mean arterial pressure in clonidine group from 35 mins till the end of surgery
(p<0.005).
Conclusion: We recommend the use of intrathecal clonidine 75 μg as adjuvant to bupivacaine with a caution to take care of hemodynamic
compromise, if any.


Keywords


Analgesia, bupivacaine, clonidine, intrathecal

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