Comparative study of intrathecal fentanyl and clonidine as adjuvants to hyperbaric bupivacaine under spinal anaesthesia in infraumbilical surgeries

Abstract

Background: Opioids are commonly used neuraxial adjuvants with local anaesthetics in subarachnoid block (SAB) for prolongation of analgesia, however Clonidine has shown to improve the quality of blockade without any neurotoxicity. This study assess the quality of SAB using intrathecal fentanyl and clonidine with bupivacaine in infraumbilical surgeries. Methods: After obtaining ethical clearance and informed consent 80 patients were randomly allocated into 2 groups, Group F received 15µg fentanyl and group C received 30µg clonidine with 12.5mg hyperbaric bupivacaine each. The onset time to reach peak sensory and motor level, 2 segment regression time, total duration of motor and sensory blockade, time for first rescue analgesia, hemodynamic changes and side effects were recorded. Results: The patients in group C had significantly prolonged sensory and motor blockade and less and delayed requirement of rescue analgesic than in group F. Conclusion: Intrathecal clonidine as adjuvant is better than fentanyl as it prolongs motor and sensory block and reduced demand of rescue analgesic.