Abstract
Background: Previous studies have shown that clonidine given intrathecally in higher doses cause side effects. In this study, we used low dose clonidine intrathecally (1 μg /kg) as adjuvant to bupivacaine to study efficacy of analgesia and side effects. Method: 60 patients were randomly divided into two groups of 30 patients each. They were aged 20 to 60 years, of ASA Class I and II undergoing genitourinary surgeries. The clonidine group (A) received 1 μg/kg clonidine in addition to bupivacaine 12.5mg (0.5%) and control group (B) received an identical volume of saline mixed with 12.5mg (0.5%) bupivacaine. Efficacy of spinal analgesia was compared between these two groups. Results: Duration of analgesia, motor block, highest level of sensory block and time taken for regression of sensory analgesia by two segments was more in the clonidine group. There was a reduction in heart rate and systolic blood pressure which was statistically insignificant. Side effects like nausea and sedation were insignificant. Conclusion: Addition of low dose clonidine (1μg/kg) to bupivacaine increases the duration of spinal analgesia as compared to bupivacaine alone with clinically insignificant influence on haemodynamic parameters and level of sedation. DOI: http://dx.doi.org/10.4038/slja.v20i1.3072 Sri Lankan Journal of Anaesthesiology 20(1): 49-52 (2012)
Highlights
Previous studies have shown that clonidine given intrathecally in higher doses cause side effects
Duration of analgesia, motor block, highest level of sensory block and time taken for regression of sensory analgesia by two segments was more in the clonidine group
Intrathecal clonidine has proven to be a potent analgesic, free of at least some of the opiod related side effects[4]. It has been used as the sole anaesthetic agent as well as admixed with opiods and local anaesthetic in labour analgesia and orthopaedic surgery
Summary
With the approval of the Hospital Ethics Committee and written informed consent of the patient, 60 patients (randomly divided into two groups of 30 each) aged 20 to 60 years and ASA Class I and II undergoing genitourinary surgeries like TURP, lower ureteric stones for endoscopy were included in the study. Patients with heart rate less than 60, systolic blood pressure less than 100 and history of uncontrolled hypertension, cardiac disease and allergy to any of the study drugs were excluded. This was a prospective, randomized double blind study. Patients in the clonidine group (A) received a single dose of 12.5mg of 0.5% bupivacaine (heavy) plus 1 μg/kg preservative free clonidine(150 μg/ml) and the patients in the control group (B) were given 12.5mg of 0.5% bupivacaine (heavy) mixed with an identical volume of saline to keep the volume of the drug identical in the two groups
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