Comparative Evaluation of Efficacies of Clonidine and Dexmedetomidine as an Adjuvant to Intrathecal Hyperbaric 0.5% Bupivacaine in Patients Scheduled for Elective Lower Limb Surgeries

Abstract

Background and Aim: Several adjuvants have been utilized to enhance the standard of analgesia over the time of post-surgery. We have undertaken this study to evaluate and compare the efficacies of clonidine and dexmedetomidine as an adjuvant to intrathecal hyperbaric 0.5% bupivacaine in patients scheduled for elective lower limb surgeries. Material and Methods: The present study is blinded randomized case control done in the department of the Emergency Medicine in the medical college and associated hospital. All patients undergoing elective lower limb surgery were included for the study. After obtaining the consent letter signed from the patients; total of 180 patients were included in the study. Patients were divided into 3 groups: Group A (control group): received 15mg of 0.5% hyperbaric bupivacaine with 0.5 ml normal saline. Group B (clonidine group): received 15mg of 0.5% hyperbaric bupivacaine with 50µg clonidine. Group C (dexmedetomidine group): received 15mg of 0.5% hyperbaricbupivacaine with 5µg dexmedetomidine. Various parameters were examined were: Onset of sensory blockade and motor blockade, Maximum level of sensory blockade and time taken for the same, Maximum level of motor blockade and time taken for the same. Results: There is no clinical significance between group B and group C regarding mean time taken for onset of sensory blockade. The mean duration of analgesia is 194 ± 26.98 mins in group A (controlgroup), 346.37 ± 32.16 mins in group B (clonidine group) 373.37 ± 38.17 mins in group C (dexmedetomidine group). There is a statistically highly significant difference between group A and group B. Conclusion: The supplementation of bupivacaine with dexmedetomidine 5 μg or clonidine 50 μgin spinal anaesthesia produces significant shorter onset of motor and sensory block with longer duration of sensory and motor block when compared to bupivacaine alone.