Abstract
Background: The newer adjutants for spinal anaesthesia (SA) have seen numerous modifications over the last two decades. Various doses of clonidine have been tried in past but optimal dose which balances the ill effects has to be discovered. Therefore, this study was designed to study the effect of clonidine as an adjuvant in SA in terms of duration and complication.
 Methods: Two groups I and II ( with 60 patients each) received either 3.0 ml of Bupivacaine 0.5% heavy + 0.5 ml of normal saline and 2.5 ml of bupivacaine 0.5% heavy + 0.5 ml (75µg) of preservative free clonidine respectively. Various haemodynamic parameters and complication were recorded at baseline than 30 min, 1,2,4,6 and 8 hours after SA.
 Results: Group II shows that addition of clonidine had altered the heart rate and blood pressure significantly for initial two hour duration(p<0.05). No difference in the onset of sensory and motor blockade in both groups. Majority of patients in both group had level of sensory block upto T7 level. Mean VAS score was significantly lower in group II (p<0.001). Group II has prolonged duration of motor blockade (p< 0.00l). The difference in mean duration of analgesia among both the groups was significant indicating that addition of clonidine prolongs the duration of analgesia (p<0.0001). In group II incidence of hypotension and bradycardia is more as compared to group I.
 Conclusion: Intrathecal clonidine in the dose of 75 µg along with bupivacaine 0.5% heavy prolonged postoperative analgesia and motor blockade. It produces sedation in which patients were asleep and easily arousal and haemodynamic changes which could be easily managed.
 Keywords: Intrathecal, Bupivacaine, Clonidine, Orthopedics surgeries, VAS score
Highlights
The quest for safer and newer adjutants for spinal anaesthesia (SA) has seen numerous modifications over the last two decades [1, 2]
Intrathecal and oral Clonidine, a α2 adrenergic agonist, has been shown to result in the prolongation of the sensory blockade and the reduction in the amount or the concentration of local anesthetic required to produce post operative analgesia[3 ].It has the ability to prolong the motor blockade produced by bupivacaine
Optimal doses of clonidine as an adjuvant to local anesthetic producing prolonged post operative analgesia and minimal side effects would be a true alternative to opioids with their dangerous side effects
Summary
The quest for safer and newer adjutants for spinal anaesthesia (SA) has seen numerous modifications over the last two decades [1, 2]. Optimal doses of clonidine as an adjuvant to local anesthetic producing prolonged post operative analgesia and minimal side effects would be a true alternative to opioids with their dangerous side effects. This study was designed to study the effect of clonidine as an adjuvant to bupivacaine heavy, given intrathecally for prolonging the duration of analgesia and to compare the efficacy in terms of duration and complication. Conclusion: Intrathecal clonidine in the dose of 75 μg along with bupivacaine 0.5% heavy prolonged postoperative analgesia and motor blockade. It produces sedation in which patients were asleep and arousal and haemodynamic changes which could be managed.
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