A COMPARISON BETWEEN INTRATHECAL DEXMEDETOMIDINE AND CLONIDINE AS ADJUVANT TO HYPERBARIC BUPIVACAINE IN SPINAL ANAESTHESIA FOR UROLOGICAL SURGERIES

Abstract

Introduction-: The present study was designed to compare the effect of two intrathecal α-2 agonists with bupivacaine in spinal anesthesia for urological procedures. Patients undergoing urological procedures under spinal anaesthesia are usually elderly having comorbid conditions. α-2 agonists is being used as an adjuvant in spinal anaesthesia with improved quality of anaesthesia and analgesia and minimal side effects. Aims and objectives-: The aim of this study is to compare the effects of intrathecal dexmedetomidine and clonidine as adjuvants to hyperbaric bupivacaine with respect to onset and duration of sensory and motor blockade duration of analgesia and incidence of side effects. Materials and methods-: This study was conducted in the Department of Anaesthesiology at a tertiary care hospital in Mumbai, from July 2014 to June 2016 with prior permission from the Institute Ethics Committee after fullling all the criteria. 90 patients (Age between 21-75 years, and weight 50 kg and above) undergoing various elective urological surgeriesunder subarachnoid blockin Department of Anaesthesiology and Critical Care were enrolled in the study. Result- The duration of anaesthesia was signicantly longer (p-value < 0.05) in Group B (Mean 442.87, SD 48.31, SE 11.11) in comparison with Group A (Mean 261.11, SD 39.56, SE 7.78) and Group C (Mean 335.91, SSD 29.98, SE 9.93). Hence it's apparent that addition of Dexmedetomidine or Clonidine to Hyperbaric Bupivacaine signicantly prolonged the duration of anaesthesia. Conclusions: α2-agonists with hyperbaric bupivacaine intrathecally have a faster onset of both motor and sensory block. It also prolongs the duration of analgesia.