297: The comparison of intratechal isobaric ropivacaine and isobaric ropivacaine-clonidine for caesarean delivery

Abstract

Aim: We investigated the effects of intrathecal isobaric 0.5% ropivacaine and isobaric 0.5% ropivacaine-clonidine combination in women undergoing caesarean deliveries. Methods: Twenty-five parturients received 17.5 mg ropivacaine (group R) and twenty five parturients received 15 mg ropivacaine and 30 μg clonidine (group RC) for spinal anaesthesia. Sensory and motor block properties; haemodynamics, postoperative analgesia, foetal outcomes and side effects were evaluated. Unpaired and paired-t-tests and chi-square and Mann-Whitney-U tests were used where appropriate (p<0.05). Results: Intrathecal ropivacaine and ropivacaine-clonidine provided effective sensory anaesthesia and motor block. S2 dermatome regression time was longer in ropivacaine-clonidine combination. First minute APGAR was lower in group RC (mean 8.8±0.7) than group R (mean 9.3±1.0). Umbilical venous pH and fifth minute APGAR scores were similar between the groups. Postoperative analgesia was prolonged by clonidine. Although intraoperative ephedrine requirements (mg) were higher in ropivacaine-clonidine group, the number of patients requiring ephedrine and the number of hypotension episodes were similar. Dry mouth was observed more with clonidine. Conclusion: We concluded that, intrathecal 17.5 mg 0.5% isobaric ropivacaine provides efficient and safe anaesthesia for caesarean section delivery. The addition of 30 g clonidine to 15 mg 0.5% isobaric ropivacaine results in longer complete and effective analgesia with similar block properties. In both groups, hypotension was easily treated with ephedrine and did not affect maternal and neonatal outcome.