A clinical comparative study between dexmedetomidine v/s clonidine with bupivacaine intrathecally in major orthopaedic lower limb surgery

Abstract

Background: We compared intrathecal Bupivacaine with either Dexmedetomidine or Clonidine. Aims: 1. To review the literature 2. Sensory and Motor Characteristics and 3. Total duration of Post-op analgesia Material and Methods: 90 patients of either sex, age 20-50 years, ASA grade I or II undergoing orthopedic lower limb surgery were randomly divided in group D (0.5%Bupivacaine15mg+Dexmedetomidine3µg) and group C (0.5%Bupivacaine15mg+Clonidine30µg) intrathecally. All parameters were recorded. Results: Mean time for onset of sensory block at shin of tibia and onset of motor block were comparable. The mean time to achieve T10 sensory blockade was 5.822 ±2.38 minutes in group D while 6.5 ±2.33minutes in Group C. With regard to the highest sensory level attained, both groups were comparable. Mean time to achieve complete motor block was 8.177 ±2.124 minutes in group D while 9±2.044 minutes in group C. The time for two segment regression was also comparable in both the groups. The mean of total duration of motor block in group D was 254.44±40.65minutes compared to 262.22±34.23 minutes in clonidine group. The time for sensory block was 296.889±38.3063 minutes in group D and 306.22±35.63 minutes in group C. Total duration of postoperative analgesia was also same in both groups. Haemodynamic stability was maintained and side effects were comparable. Conclusion: We conclude that both Dexmedetomidine and Clonidine when used as an adjuvant to intrathecal hyperbaric Bupivacaine cause early onset of motor and sensory block, increases two segment regression time, prolonged motor, sensory blockade and post-operative analgesia with hemodynamic stability and no side-effects. Keywords: Dexmedetomidine, Clonidine, Bupivacaine, Intrathecal