Comparison of clonidine and dexmedetomidine as an adjuvant to bupivacaine for PNS guided femoral-sciatic nerve block for post-operative analgesia in below knee surgeries under spinal anaesthesia.

Abstract

Title: Comparison of Clonidine and Dexmedetomidine as an adjuvant to Bupivacaine for PNS guided femoral-sciatic nerve block for post-operative analgesia in below knee surgeries under spinal anaesthesia.Background: In patients undergoing lower limb orthopaedic surgeries, regional anaesthesia like subarachnoid blocks are safe, having excellent analgesia for shorter duration of time. To provide prolonged analgesia femoral-sciatic nerve block (FSNB) is reliable, safe and effective method in immediate post-operative period.Aim: To assess the duration of analgesia after FSNB and Compare efficacy of equal doses of clonidine and dexmedetomidine as an adjuvant to bupivacaine for post-operative analgesia in below knee orthopedic surgeries.Material and Methods: 60 ASA I and II patients admitted under orthopaedic wards for below knee surgeries were randomly divided into 2 groups of 30 each: Group C 0.125% Bupivacaine 25cc + 0.5mcg/kg Clonidine and Group D 0.125% Bupivacaine 25cc + 0.5mcg/kg DexmedetomidineStatistical analysis:-The inter-group statistical comparison of categorical variables is tested using Chi-Square test or Fisher’s exact probability test and of continuous variables is done using independent sample t test.Results: The duration of analgesia was significantly prolonged in group D (10.17 ± 1.80 h) as compared to group C (7.0 ± 1.36 h) and the difference was statistically significant. Conclusion: Our study demonstrated that addition of dexmedetomidine to bupivacaine in femoro sciatic nerve block prolonged the duration and improved the quality of analgesia as compared to clonidine with hemodynamic stability and lack of side effects.