INTRATHECAL CLONIDINE AS ADJUNCT TO HYPERBARIC BUPIVACAINE: A DOSE COMPARATIVE STUDY

Dr. Hema Saxena, Dr. Deepika Tiwari, Dr. Atul Kumar Singh

Abstract


Background: Many studies in past have shown that addition of clonidine (15-30 µg) to intrathecal local anaesthetic improves intraoperative analgesia and increases the duration of sensory and motor block. We conducted a prospective randomised double blinded study to evaluate the lowest dose of intrathecal clonidine as adjunct to hyperbaric bupivacaine that will produce maximum benefit with minimum side effects.

Material and methods: Eighty patients of ASA grade I and II, scheduled for total abdominal hysterectomy (TAH) under spinal anaesthesia were divided randomly into four groups. Control group (Group I) received 13.5mg 0.5% hyperbaric bupivacaine. Study groups received 15µg (Group II), 30µg (Group III) and 45µg (Group IV) made to 3ml volume with 13.5mg 0.5% hyperbaric bupivacaine.

Result: The mean time of onset of block was lower while duration of analgesia and motor blockade was prolonged in all clonidine groups (Group IV > Group III > Group II). The change was less significant in Group III and IV. 40% patients in Group IV and 20% patients in Group III had significant fall in mean arterial blood pressure (MAP). 60% patients in Group IV and 20% in Group III developed bradycardia. 90% patients were sedated in Group IV.

Conclusion: We concluded that addition of clonidine to intrathecal bupivacaine significantly reduces the onset time of sensory and motor block, prolongs duration of spinal block with 30µg being optimum dose.


Keywords


Intrathecal clonidine, bupivacaine, subarachnoid block.

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