A COMPARATIVE RANDOMISED STUDY OF EFFECT OF INTRATHECAL CLONIDINE AS AN ADJUVANT TO INTRATHECAL LEVOBUPIVACANE AT DIFFERENT DOSES TO DETERMINE THE OPTIMUM DOSE IN LOWER ABDOMINAL SURGERIES

Abstract

Background and Aims: Clonidine is widely used as an adjuvant to spinal anaesthesia to improve quality of anaesthesia but with haemodynamic side effects with increasing dose. We have conducted a study to observe the effects of Clonidine as an adjuvant to intrathecal isobaric levobupivacaine at different doses in terms of time to onset, duration and quality of block along with hemodyanamic changes to determine the optimal dose. Methods: Seventy-ve patients were divided randomly in three groups of 25 patients each who got admitted for lower abdominal surgeries. Group LC15: 0.5% 15mg 3 ml levobupivacaine with Clonidine 15µg (0.1ml) and 0.4cc of normal saline. Group LC30: 0.5% 15mg 3 ml levobupivacaine with Clonidine 30µg (0.2ml) and 0.3ml of normal saline. 0.5% 15mg 3 ml levobupivacaine with Group LC45 : Clonidine 45µg (0.3ml) and 0.2ml of normal saline. volume of drug was equal in all three groups. The time to onset Results: of sensory as well as motor block was decreased in dose dependant manner, was least in group LC45 and most in group LC15 (Pvalue=0.0001). The two segment regression, duration of analgesia was most in group LC45 (Pvalue=0.0001). There was signicant fall (>80%) in blood pressure in group LC45 seen in 9 cases out of 25 (36%) than in group LC30 seen in 3 cases out of 25 (12%) and LC 15 seen in 0 cases. the optimum dose of Clonidine as an adjuvant to sp Conclusion: inal anaesthesia given with intrathecal isobaric levobupivacaine 0.5% was 30µg with dose dependant decrease in duration to onset of sensory and motor blockade and prolonged postoperative analgesia with haemodynamic stability most with 30µg dose.