Dexmedetomidine versus clonidine as an adjunct to intrathecal small dose ropivacaine in patients undergoing transurethral resection of prostate

Abstract

Context It is important to limit the cephalad spread of local anesthetic above T10 dermatome during spinal anesthesia in patients undergoing transurethral resection of prostate (TURP). This can be achieved by using small dose of local anesthetics in combination with intrathecal additives such as α 2 -agonists, which improve the quality of block without altering the height of block. Aims The aim of the study was to compare dexmedetomidine and clonidine when added to intrathecal ropivacaine in patients undergoing TURP. Settings and design The study was designed as a prospective, randomized, and double-blind study. Materials and methods Fifty patients of ASA grade I-III, scheduled for elective TURP, were allocated into two groups. Group I received 7.5 mg ropivacaine+15 μg clonidine and group II received 7.5 mg ropivacaine+5 μg dexmedetomidine. Spinal anesthesia was administered in the sitting position after preloading the patients with 10 ml/kg Ringer's lactate. Onset, duration, and peak sensory level, intensity of motor block, and analgesic requirements were recorded. Results Patients in both groups had comparable baseline and demographic characteristics. Peak sensory block was similar in both groups. Patients in group II had faster onset and longer duration of sensory block. Intensity and duration of motor block were also greater in group II. The quality of intraoperative and postoperative analgesia was better in group II. Conclusion Intrathecal dexmedetomidine with ropivacaine provides faster onset, better operating conditions, and patient comfort in patients undergoing TURP. However, it is associated with delayed motor recovery.