Abstract
Background: Patients undergoing caesarean section under spinal anaesthesia often experience pain in the perioperative period. The aim of this study was to evaluate the effect of intrathecal combination of clonidine and bupivacaine compared with bupivacaine and opioid on the incidence and severity of pain in elective caesarean section cases. Materials and Methods: Ninety healthy parturient at term scheduled for elective caesarean delivery were randomly allocated to receive intrathecally hyperbaric bupivacaine alone (Group B) or combined with 75 μg of clonidine (Group C) or with fentanyl 25 μg (Group F). The peak sensory block level, time to reach peak block level from injection, time to two segment regression, maximum degree of motor block, side effects, perioperative analgesic requirements and time to the first analgesic request after surgery were recorded and statistically analysed. Results: Time to two segment regression was significantly prolonged in Group C (78.87 ± 13.362 mins.) and Group F (84.17 ± 12.463 mins.) as compared to Group B (69.70 ± 14.005 min); (P < 0.05). There was significant prolongation of postoperative analgesia as seen by the time to first analgesic request after surgery in Group C (3.550 ± 1.1013 hours) and Group F (5.183 ± 1.1706 hours) as compared to Group B (2.350 ± 0.9016 hours). (P < 0.05). There was increased incidence of hypotension and nausea in Group C compared to other two groups. Conclusion: Perioperative analgesia was prolonged by the addition of 75 μg of clonidine and 25 μg fentanyl to bupivacaine, with increased side effects of nausea, vomiting and hypotension in the clonidine group.
Published Version
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