Effects of adding different doses of clonidine to intrathecal bupivacaine for spinal anesthesia in cesarean sectionss

Abstract

Purpose: This study investigated the effects of three different doses of clonidine in combination with intrathecal hyperbaric bupivacaine on the quality of the blockade and maternal-fetal repercussions in parturients undergoing elective cesarean section. Materials an Methods: Following ethics committee approval, ASA I and II patients of age group 20-35 years, scheduled for cesarean section, were chosen for this study. Patients were randomly distributed into three equal groups of 35 patients in each using a computer-generated sequence of numbers. The patients received hyperbaric bupivacaine (two ml) with 15 μg of clonidine (BC15 group) or 30 μg of clonidine (BC30 group) or 60 μg of clonidine (BC60 group). Hemodynamic parameters, onset, peak and duration of sensory and motor block, sedation scores, Apgar scores, side effects, and duration of postoperative analgesia were compared. Results: All groups were comparable with respect to demographic profile, onset, peak and duration of sensory and motor block, and overall hemodynamic stability. The authors observed dose-dependent variability in duration of analgesia and sedation. Duration of analgesia was significantly higher in BC60 group as compared to the other two groups (577.13 ± 120.30 vs. 422.06 ± 112.47 and 376.21 ± 87.21 minutes, respectively). Sedation was also more in BC 60 group. Conclusion: Intrathecal addition of 15 and 30 μg clonidine are better options when sedation is not desirable; on the contrary, addition of 60 μg provides excellent quality of spinal analgesia when some amount of sedation is acceptable or required without any deleterious effects on the mother and baby.