Comparison of Levobupivacaine and Clonidine with Bupivacaine and Clonidine in Spinal Anaesthesia for Lower Segment Caesarean Section

Abstract

Comparison Of Levobupivacaine And Clonidine With Bupivacaine And Clonidine In Spinal anaesthesia ForLowerSegmentCaesareanSection Introduction: Intrathecal LevoBupivacaine is having similar clinical profile with less cardio-toxicity than Bupivacaine is used commonly for LSCS. Clonidine as an additive to LA provides effective, prolonged and dose dependent analgesia. In this study we compared effect of intrathecal Clonidine 30 μg and 0.5% isobaric Levobupivacaine 9 mg with Clonidine 30 μg and 0.5% hyperbaric Bupivacaine 9 mg for LSCS. Material and method : In this study we want to compare onset, degree, maximum sensory level achieved, time required to achieve the maximum level of sensory blockade, duration of effective sensory blockade and onset and degree of effective motor blockade ,its cardiac effect and effect on APGAR score of baby after intratheacal Clonidine 30 μg as an adjuvant to intrathecal 0.5% isobaric Levobupivacaine 9 mg and 0.5% hyperbaric Bupivacaine9mg. Observations:The mean time for the onset of motor blockade in patients in group B was 1.90 ± 0.54 min and in group L was 2.15 ± 0.47 min. Mean time required for maximum motor blockade was 4.70 ± 0.65 min for group B and 4.30 ± 0.59 min for group L. Time of onset of analgesia at T6 was 6.40 ± 0.81 in group B and 6.70± 0.84 min in L group. Time requited to achieve maximum level of analgesia was 7.20 ± 1.21min in group B and 7.33 ± 1.26 min in group L. Bradycardia was statistically significant in patients of group B as compared to that in group L. Two dermatome regression in group B was at 158.27 ± 5.01 min and in group L it was at 157.83 ± 3.49 min. The first rescue analgesic required in group B was at 167.68 ± 3.84 min and in group L was at 165.73 ±4.65min. Conclusion:We observed that that isobaric Levobupivacaine with Clonidine has got comparable pharmacokinetic in onset and offset of sensory and motor block, less cardiovascular side effects, good intraoperative and postoperative analgesia without sedation and adverse effect on Apgar score so we conclude that Levobupivacaine with Clonidine is a better choice in LSCS than Bupivacaine with Clonidine.