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ORIGINAL ARTICLE
Year : 2018  |  Volume : 13  |  Issue : 1  |  Page : 4-8

A comparative study of equipotent doses of intrathecal clonidine and dexmedetomidine on characteristics of bupivacaine spinal anesthesia


Department of Anesthesia, JNMC, Sawangi (M) Wardha, Maharashtra, India

Correspondence Address:
Dr. Rahul Rajan
Department of Anesthesia, JNMC, Sawangi (M) Wardha, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jdmimsu.jdmimsu_59_18

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Background: We compared the onset and duration of sensory block, onset and duration duration of motor block, analgesia time, and adverse effects along with the hemodynamic changes, following intrathecal administration of dexmedetomidine or clonidine with bupivacaine. Materials and Methods: A total of 120 ASA Grade I or II patients, aged between 18 and 60 years, were enrolled in the study. The patients were randomly allocated to three equal groups: Group B received hyperbaric bupivacaine (0.5%) 15 mg with normal saline as a placebo, Group D received bupivacaine with 5 μg of dexmedetomidine, and Group C received bupivacaine with 50 μg of clonidine. All solutions were made up to 3.5 ml with addition of normal saline and injected at L3–L4 using a 25G spinal needle. The onset and duration of sensory and motor blockade and the sensory and motor regression times were recorded and the sedation level was also calculated. Hemodynamic changes and time to use first rescue analgesia, diclofenac sodium 75 mg IM, were also recorded. In postanesthesia care unit, pain scores were recorded using visual analog scale. Analysis of variance test was used to compare the quantitative variables in between the three groups which were independent of each other. Chi-square test was used to compare categorical variables. All the data were analyzed using SPSS (SPSS Inc., Chicago, IL)versus 17. P < 0.05 was considered statistically significant. Results: There was no significant difference in patients' demographics or duration of surgery. The time to onset of sensory block and motor block was early in Group D and Group C as compared to Group B. Duration of sensory and motor blockade was prolonged in Groups C and D, compared with Group B. Two-segment regression time was prolonged in Group C and Group D as compared to Group B. Intraoperative hemodynamics and level of sedation were clinically not significant in all the groups. Conclusion: The addition of clonidine or dexmedetomidine to intrathecal bupivacaine prolongs the motor and sensory block and postoperative analgesia when compared to bupivacaine alone with preserved hemodynamic stability in lower abdominal and lower limb surgeries.


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