Abstract
Background and Objective: Fentanyl and clonidine as adjuvants are commonly mixed with 0.5% bupivacaine heavy, by intrathecal route, for prolonging both sensory and motor blockade as well as for enhancing postoperative analgesia in patients undergoing major abdominal or lower limb surgery. This study was undertaken to compare the intraoperative effects and postoperative analgesia of fentanyl and clonidine, used as adjuvant to intrathecal bupivacaine during knee arthroplasty.
 Methodology: This prospective, randomized study was conducted on 60 patients of ASA grade I or II, between 20 and 50 years of age divided into two groups of 30 each. The patients were given 3 ml of 0.5% hyperbaric bupivacaine with either 25 mcg of fentanyl (Group F) or 50 mcg of clonidine (Group C) intrathecally. The onset of sensory and motor block, the duration of blockade, hemodynamic parameters, sedation score, total postoperative analgesia time, and side effects if any were recorded.
 Results: Both the groups were statistically comparable for demographic data, onset of sensory and motor blockade, duration of blockade and hemodynamic parameters. However, the sedation score was more in clonidine group. The duration of analgesia was significantly prolonged in clonidine group when compared with fentanyl group.
 Conclusion: In comparison to fentanyl, addition of clonidine to intrathecal bupivacaine prolongs the duration of postoperative analgesia and cause a higher sedation score.
 Key words: Bupivacaine, clonidine, fentanyl
Highlights
Addition of adjuvants to local anesthetic agents for subarachnoid block causes potentiation of the effect of blockade and causes prolongation of postoperative analgesia.[1,2,3,4,5,6] Successful intrathecal use of morphine was first demonstrated by Wang et al[7], and since many opioids have been used as adjuvant to local anesthetic agent
Background and Objective: Fentanyl and clonidine as adjuvants are commonly mixed with 0.5% bupivacaine heavy, by intrathecal route, for prolonging both sensory and motor blockade as well as for enhancing postoperative analgesia in patients undergoing major abdominal or lower limb surgery
In comparison to fentanyl, addition of clonidine to intrathecal bupivacaine prolongs the duration of postoperative analgesia and cause a higher sedation score
Summary
Addition of adjuvants to local anesthetic agents for subarachnoid block causes potentiation of the effect of blockade and causes prolongation of postoperative analgesia.[1,2,3,4,5,6] Successful intrathecal use of morphine was first demonstrated by Wang et al[7], and since many opioids have been used as adjuvant to local anesthetic agent. In this study we compared clonidine with fentanyl as adjuvant to intrathecal bupivacaine in terms of onset and duration of sensory and motor blockade as well as postoperative analgesia in patients undergoing knee arthroplasty. Fentanyl and clonidine as adjuvants are commonly mixed with 0.5% bupivacaine heavy, by intrathecal route, for prolonging both sensory and motor blockade as well as for enhancing postoperative analgesia in patients undergoing major abdominal or lower limb surgery. The onset of sensory and motor block, the duration of blockade, hemodynamic parameters, sedation score, total postoperative analgesia time, and side effects if any were recorded. Conclusion: In comparison to fentanyl, addition of clonidine to intrathecal bupivacaine prolongs the duration of postoperative analgesia and cause a higher sedation score.
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