Comparative analysis of intrathecal low dose dexmedetomidine and clonidine as an adjuvant to bupivacaine in gynaecological surgeries

Abstract

: Adjuvants play an important role in the intraoperative and post-operative analgesia. Spinal Anaesthesia is very common among gynaecological surgeries. Bupivacaine is the most common drug used for in gynaecological surgeries. So, addition of Clonidine or Dexmedetomidine as adjuvant can decrease post-operative analgesia. A randomised controlled trial was done to compare the two groups of Dexmedetomidine and Clonidine along with Bupivacaine. A total of 100 patients were divided into 50 each randomly into two groups and intrathecal medication were given as per the group allotted. : Time of onset of sensory and motor block was much faster in Dexmedetomidine group than Clonidine group. The two segment regression was slower in Dexmedetomidine group compared to Clonidine group. The time taken for two segment regression was 590 ±15 minutes and 361± 18 minutes respectively and was found to be statistically significantOnset of motor block according to Bromage grade 3 was 4.3 ±1.2 minutes and 5.14 ±1.4 among Dexmedetomidine and Clonidine group respectively. The mean values of mean arterial pressures and heart rate were similar throughout the inter operative and post-operative time duration.Planning and managing postoperative analgesia starts from pre anaesthetic evaluation. So Dexmedetomidine when used along with Bupivacaine intrathecally has better postoperative pain relief as compared with Clonidine and Bupivacaine.