Different Doses Of Clonidine Research Articles

Synergistic interaction between clonidine and ACPA on the modulation of anxiety-like behaviors in non-acute restraint stress and acute restraint stress conditions

The present research examined the possible role of α-2 adrenergic receptor drugs (clonidine, selective α-2 adrenergic receptor agonist, and yohimbine, competitive α-2 adrenoreceptor antagonist,) on the effect of arachidonylcyclopropylamide (ACPA), a cannabinoid CB1 receptor agonist, in non-acute restraint stress (NARS) and acute restraint stress (ARS) mice. The animals were unilaterally implanted with a cannula in the left lateral ventricle. ARS was carried out by movement restraint at a period of 4 h. An elevated plus-maze (EPM) apparatus was used to evaluate anxiety-like behaviors. The results indicated that induction of ARS for 4 h induced anxiogenic-like behavior due to the reduction of %OAT (the percentage of time spent in the open arms) in male mice. Additionally, ARS caused neuronal degeneration in the prefrontal cortex. On the other hand, alone intracerebroventricularly (i.c.v.) infusions of ACPA (0.5 µg/mouse) and clonidine (0.5 µg/mouse) increased %OAT, indicating an anxiolytic-like response in the NARS and ARS mice. In contrast, alone i.c.v. infusions of yohimbine (0.5 µg/mouse) decreased %OAT and %OAE (the percentage of entries to the open arms), proposing an anxiogenic-like effect in the NARS and ARS mice. When the subthreshold dose of ACPA and different doses of clonidine were co-injected, ACPA potentiated the anxiolytic-like behavior produced by clonidine in the ARS mice. On the other hand, when the ineffective dosage of ACPA and different dosages of yohimbine were co-infused, ACPA reversed the anxiogenic-like effect induced by yohimbine in the NARS and ARS mice. Moreover, the results revealed a synergistic effect between ACPA and clonidine upon induction of anxiolytic-like behaviors. It can be concluded that the interaction between clonidine and ACPA modulates the anxiety-like behaviors induced by stress in male mice.

“TWO DIFFERENT DOSES OF INTRATHECAL CLONIDINE FOR POST - OPERATIVE ANALGESIA IN LOWER LIMB SURGERIES - A COMPARISON"

Background and Aim : Clonidine is added to intrathecal bupivacaine to increase the duration of block and provide postoperative analgesia. The study aimed to compare two different doses of clonidine with bupivacaine in lower limb surgery, and to know the optimal analgesic dose of clonidine. In this single blind randomize Methods: d, prospective comparative study, forty patients of the ASA grade I or II, posted for lower limb surgery, were randomly allocated into two groups. Group C-30 received 3 mL of 0.5% hyperbaric bupivacaine with 30 µg of clonidine and Group C-15 received 3 mL of 0.5% hyperbaric bupivacaine with 15 µg of clonidine. The mean onset of block, regression by two segments, duration of analgesia , hemodynamic parameters and adverse effects were assessed. Data analysis was done with statistical software SPSS Ver. 20 with Unpaired T test and Chi-square test. Onset of block was signicantly faster (p < 0.01) with Results: Group C30 than Group C15 ( 0.98 ± 0.07 min vs 1.34 ± 0.19 min) , whereas regression by two segments(192.45 ± 10.69 min vs 168.20 ± 7.89 min) and duration of analgesia (233.25 ± 23.23 mins vs 179.75 ± 9.06min) was signicantly prolonged in Group C30 than Group C15. Incidence of adverse events was comparable and not statistically signicant (p > 0.05) in Group C15 (40%) than in Group C30 (60%). Both doses Conclusion: of clonidine provide equally safe, effective and excellent quality of post-operative analgesia. 30mcg of Clonidine is the optimal analgesic dose for lower limb surgeries due to faster onset , longer time for regression by two segments and prolonged duration of post-operative analgesia without any signicant adverse effects.

Comparison of intrathecal bupivacaine with different doses of clonidine for spinal anesthesia in adults: A systematic review

Background: Evaluating the optimal dose of intrathecal clonidine adjuvant has a great impact on day-to-day practice of anesthesia, as spinal anesthesia is one of the most commonly performed anesthetic procedure.Objectives: Evaluate for the minimal dose of intrathecal clonidine as an adjunct to bupivacaine heavy for spinal anesthesia that can produce optimal sensory and motor blockade with minimal hemodynamic effects.Methods: Randomized control trials carried out on adult patients, of both genders undergoing elective infraumbilical surgeries under spinal anesthesia with bupivacaine heavy and different doses of clonidine having ethical committee approval were included and articles published in non-English languages were excluded. Databases (PubMed and Google Scholar) and websites of the Indian Journal of Anaesthesia and anesthesia essays and researches journals were systematically searched and interpreted in accordance with the PRISMA guidelines. Quality assessment was done using the Risk of Bias assessment 2.O tool. The mean time taken for the onset of sensory and motor blockade, mean duration of sensory and motor blockade and significant adverse effects were the key outcome variables. Nonstatistical synthesis of quantitative data of the selected articles was done.Results: The efficacy in terms of sensory and motor blockade was comparatively more with 1 μg/kg of intrathecal clonidine than with lower doses, however, cardiovascular adverse effects were dose-dependent, with 15 μg intrathecal clonidine causing least cardiovascular disturbance.Conclusion: 15–30 μg intrathecal clonidine as an adjunct to bupivacaine heavy would produce optimal sensory and motor block with minimal hemodynamic disturbances.

Comparison of Bupivacaine with Two Different Doses of Clonidine under Spinal Anaesthesia in Infraumbilical SurgeriesA Randomised Clinical Study

Introduction: Spinal anaesthesia is known as a safe and effective way to give anaesthesia during infraumbilical and lower limb surgeries. Intrathecal clonidine is a safe non opioid adjuvant used with local anaesthetics to prolong sensory and motor block, promotes sedation and analgesia. Aim: To compare the effects of bupivacaine with two different doses of clonidine under spinal anaesthesia in infraumbilical surgeries. Materials and Methods: This randomised double-blinded study was conducted in the Department of Anaesthesiology at Hind Institute Of Medical Science, Sitapur, Uttar Pradesh, India. The duration of the study was 19 months, from January 2021 to August 2022. A total of 60 patients (36 males and 24 females) were enrolled in the study and were randomly assigned to one of two groups (group A and group B) of 30 patients each. Group A bupivacaine heavy 12.5 mg with 15 mcg of clonidine, total volume 3 mL and group B bupivacaine heavy 12.5 mg with 30 mcg of clonidine, total volume 3 mL. The study parameters were: onset of sensory and motor block, duration of postoperative analgesia and any side effects (hypotension, bradycardia, sedation or any other). The statistical analysis was done using Statistical Package for Social Sciences (SPSS) Version 21.0. Results: The mean age of the study participants group A (44.51±12.84) years and group B (42.28±13.12) years. The demographical data showed comparable findings. The mean of onset of sensory (160.37±33.64) seconds and motor block (197.2±12.36) seconds in group B was statistically lower than group A. The mean duration of analgesia in group A (302.58±18.62) minutes was lower than group B (318.73±29.46) minutes. The mean Visual Analogue Scale (VAS) score was higher at every follow-up in group A as compared to in group B. The mean Ramsay sedation score was significantly higher in Group B at every follow-up than in group A. Conclusion: Spinal anaesthesia performed with 0.5% bupivacaine heavy with 30 mcg clonidine was proven to be a more effective adjuvant in providing early onset of the sensory and motor blockade intraoperatively and prolongation of the duration of effective postoperative analgesia when compare to 15 mcg clonidine.

Analysis of intrathecal clonidine as an adjuvant in the subarachnoid block on post-operative analgesia and safety profile in obstetric surgeries: A randomised controlled trial

Background: Clonidine has long been considered an 'off-label' medication for use in obstetrics. Different doses of clonidine are studied and it is found that higher doses are associated with sedation and haemodynamic instability. Hence, we analysed a mini dose of intrathecal clonidine of 30 μg for its impact primarily on post-operative analgesia and secondarily on the quality of spinal anaesthesia, haemodynamics, sedation and neonatal outcomes in caesarean sections.Methods: One hundred participants were randomised them to receive the interventions. Group B received 11 mg of 0.5% hyperbaric bupivacaine (2.2 mL) and Group C received 10 mg of 0.5% hyperbaric bupivacaine with 30 μg of clonidine (2.2 mL). Motor, sensory and haemodynamic characteristics with time to rescue analgesics were observed in both the groups and analysed using univariate analysis.Results: Time to rescue analgesics (P < 0.001), visual analogue scores in the post-operative period and time to grade 0 Bromage (P = 0.002) were statistically significant in Group C. Time to T6 dermatomal level and time to grade 4 Bromage were similar in both the groups. Apgar scores were comparable and no adverse events were noted in both the groups.Conclusions: A low dose of intrathecal clonidine (30 μg) can prolong the duration of post-operative analgesia in caesarean section with comfortable maternal sedation and good neonatal outcome without significant complications.(Clinical Trials Registry- India, number CTRI/2018/08/015250)

Clinical Evaluation of Two Different Doses of Clonidine as an Adjuvant to Bupivacaine in Ultrasound-Guided Supraclavicular Brachial Plexus Block for Pediatric Upper Limb Surgeries - A Randomized Trial

Clonidine as an adjuvant to local anesthetic for regional anesthesia in upper limb surgeries has been extensively studied in adults, but there is a paucity of data regarding the dose of clonidine which is effective and safe as an adjuvant in children. To find the dose of clonidine that prolongs the duration of analgesia without prolonging the side effects. Prospective, randomized, double-blind study. After taking informed consent from the parents/guardian, 42 children aged 3-12 years who were scheduled to undergo unilateral upper limb surgeries below the elbow were randomized into two groups of 21 each. Group A was given 0.5 μg.kg-1 of clonidine in addition to 0.5 mL.kg-1 of 0.25% bupivacaine and Group B received 1 μg.kg-1 of clonidine added to the same volume and concentration of local anesthetic for supraclavicular brachial plexus block under general anesthesia using ultrasound guidance. The drug administration and the recording of the observations were done by an investigator blinded to the dose of clonidine. Statistical testing was conducted with the Statistical Package for the Social Sciences system version SPSS 17.0. The demographic parameters and baseline hemodynamic parameters were similar in the two groups. The block failed in one child in Group A. One patient in Group A required tramadol postoperatively while none of the patients in Group B required tramadol. The mean duration of analgesia (11.35 ± 1.54 h vs. 9.94 ± 1.04 h, P < 0.001) and the duration of motor block (8.86 ± 1.0 h vs. 7.77 ± 0.55 h, P < 0.001) were significantly higher in group B. Sedation scores were higher in the recovery room in Group B. Deep sedation, bradycardia, and respiratory depression were not observed in any of the cases. Clonidine 1 μg.kg-1 when added as an adjuvant to bupivacaine for pediatric supraclavicular brachial plexus block prolongs the duration of analgesia and motor block as compared to the dose of 0.5 μg.kg-1. However, this was at the cost of increased duration of motor block and sedation. Considering the clinical equivalence of the effect, a lower dose of clonidine would be preferable to avoid the undesirable effects.

A comparative study on efficacy of two different doses of clonidine added to hyperbaric bupivacaine in spinal anaesthesia in sub umbilical surgeries

A comparative study on efficacy of two different doses of clonidine added to hyperbaric bupivacaine in spinal anaesthesia in sub umbilical surgeries

Comparison of Different Doses of Clonidine as an Additive to Intrathecal Isobaric Levobupivacaine in Patients Undergoing Infraumbilical Surgeries.

Background:Spinal anesthesia is a safe, reliable, and inexpensive technique with the advantage of providing surgical anesthesia and prolonged postoperative pain relief, and it also blunts autonomic, somatic, and endocrine responses to surgical stimulus.Aim:The aim of this study was to assess the efficacy 15 μg and 30 μg of intrathecal clonidine along with 3 mL of 0.5% isobaric levobupivacaine in comparison with plain 0.5% isobaric levobupivacaine.Setting and Design:The prospective, interventional, randomized, comparative, double-blinded study was conducted after obtaining approval from the institutional ethical committee.Materials and Methods:Seventy-five patients posted for elective lower-limb orthopedic surgeries were randomly divided into three groups with 25 patients in each group as L (levobupivacaine 0.5%), LC-15 (levobupivacaine 0.5% + clonidine 15 μg), and LC-30 (levobupivacaine 0.5% + clonidine 30 μg). All the patients were given spinal anesthesia using the study drugs, and various parameters were monitored.Statistical Analysis:The three groups were compared statistically using analysis of variance and Student's t-test (independent samples t-test). P < 0.05 was considered statistically significant.Results:There was a statistically significant difference among the three groups with respect to the onset of time for maximum sensory blockade and duration of analgesia. A statistically significant difference was noted among the three groups with respect to the onset of time for maximum motor blockade.Conclusion:Both doses of clonidine produced prolonged sensory block compared to the control. It has been found that 30 μg of clonidine as an adjuvant has produced faster onset and prolonged duration sensory block compared to 15 μg of clonidine.

Comparative study of different doses of clonidine as an adjuvant with isobaric levobupivacaine for spinal anaesthesia in patients undergoing caesarean section

Background: Various techniques of central neuraxial blockade have been tried and successfully used for caesarean section surgeries. Nowadays it is must and essential to know the possible effective dose of clonidine to overcome its known side effect like bradycardia, hypotension and sedation for better outcome of mother as well as foetus in lower segment caesarean section. We have conducted such study to compare different doses of clonidine as an adjuvant to intrathecal isobaric levobupivacaine. The plain levobupivacaine has been shown to truly isobaric with respect to CSF of pregnant women and this property got advantage over hyperbaric bupivacaine in its predictable spread. Materials and Methods: There were about 90 cases of emergency caesarean section of more than 37 weeks gestation with ASA physical status class 2 under spinal anaesthesia were randomly divided into three groups of 30 patients each. In all groups we assessed onset, two segment regression and requirement of analgesic in post-operative period, level of motor block by modified bromage scale [Table 1] and sedation by Campbell sedation score [Table 2]. Maternal and foetal hemodynamic was monitored as well. Group A (n = 30) 10 mg of 0.5% (2 ml) isobaric levobupivacaine + 15 mcg clonidine (0.5 ml). Group B (n = 30) 10 mg of 0.5% (2 ml) isobaric levobupivacaine + 30 mcg clonidine (0.5 ml). Group C (n = 30) 10 mg of 0.5% (2 ml) isobaric levobupivacaine + 45 mcg clonidine (0.5 ml). Normal saline was used to make volume of clonidine upto 0.5 ml. Result: Onset of sensory block was highest in group A with significant difference (P value

Combination of clonidine–bupivacaine in caudal epidural anesthesia for hypospadias surgery in children: prospective, randomized, blind study

Background and objectivesThe combination of clonidine with local anesthetic administered for epidural anesthesia via caudal route seems to improve the quality of postoperative analgesia, but with conflicting results. This study compared the postoperative analgesia of three different doses of clonidine combined with bupivacaine in caudal epidural anesthesia in children undergoing hypospadias repair. MethodsEighty children aged 1–10 years, candidates for surgical repair of hypospadias, were randomly divided into four groups of 20 patients to receive general anesthesia combined with caudal epidural anesthesia with bupivacaine 0.165% alone or in combination with 1, 2 or 3μg.kg−1 of clonidine. The primary outcome was morphine consumption in the first 24h postoperatively. Mean arterial pressure, heart rate, end-tidal concentration of sevoflurane, time to awakening, pain severity (FLACC scale), level of sedation (RAMSAY), duration of analgesia, and occurrence of adverse effects were also compared. ResultsIntraoperatively, there was no difference between groups regarding mean arterial pressure, heart rate, end-tidal concentration of sevoflurane, and time to awakening. Postoperative morphine consumption and pain severity were similar between groups, but the group receiving clonidine (3μg.kg−1) had lower heart rate and higher sedation level than the group receiving bupivacaine alone. ConclusionsThe combination of clonidine at doses of 1, 2 or 3μg.kg−1 with bupivacaine 0.16% via caudal epidural route did not alter the consumption of morphine in the early postoperative period of children undergoing hypospadias repair.

Associação clonidina‐bupivacaína na anestesia peridural caudal para cirurgia de hipospádia em crianças: estudo prospectivo, randomizado, encoberto

Background and objectivesThe combination of clonidine with local anesthetic administered for epidural anesthesia via caudal route seems to improve the quality of postoperative analgesia, but with conflicting results. This study compared the postoperative analgesia of three different doses of clonidine combined with bupivacaine in caudal epidural anesthesia in children undergoing hypospadias repair. MethodsEighty children aged 1 to 10 years, candidates for surgical repair of hypospadias, were randomly divided into four groups of 20 patients to receive general anesthesia combined with caudal epidural anesthesia with bupivacaine 0.165% alone or in combination with 1, 2 or 3μg.kg‐1 of clonidine. The primary outcome was morphine consumption in the first 24hours postoperatively. Mean arterial pressure, heart rate, end‐tidal concentration of sevoflurane, time to awakening, pain severity (FLACC scale), level of sedation (RAMSAY), duration of analgesia, and occurrence of adverse effects were also compared. ResultsIntraoperatively, there was no difference between groups regarding mean arterial pressure, heart rate, end‐tidal concentration of sevoflurane, and time to awakening. Postoperative morphine consumption and pain severity were similar between groups, but the group receiving clonidine (3μg.kg‐1) had lower heart rate and higher sedation level than the group receiving bupivacaine alone. ConclusionsThe combination of clonidine at doses of 1, 2 or 3μg.kg‐1 with bupivacaine 0.16% via caudal epidural route did not alter the consumption of morphine in the early postoperative period of children undergoing hypospadias repair.

A Comparative Study of Intrathecal Bupivacaine and Bupivacaine with Different Doses of Clonidine in Lower Limb Surgeries.

Background:Intrathecal clonidine is a very safe, nonopioid adjuvant to local anesthetics to prolong the duration of analgesia without any major side effects.Objective:The purpose of the present study was to evaluate the efficacy of clonidine in two different doses as an adjuvant to bupivacaine intrathecally in lower limb surgeries.Materials and Methods:A total of 75 adult patients scheduled to undergo lower limb surgeries were randomly allocated into either of three groups of 25 patients. Group I received 12.5 mg bupivacaine, Group II patients received bupivacaine 12.5 mg with clonidine 15 μg, and patients in Group III received bupivacaine 12.5 mg with clonidine 30 μg intrathecally. A total volume of 3 ml was made in all groups using normal saline. The hemodynamic parameters, onset, and duration of sensory block, highest dermatomal level of sensory block, motor block onset, time to complete motor block recovery, and mean time to request of the first analgesic were recorded. Side effects or any other complications were noted.Results:The mean time of onset of sensory block and motor block was less in clonidine groups. The mean duration of sensory block was significantly prolonged in clonidine groups as compared to study group. The duration of motor block (in minutes) was significantly prolonged in Group III (171.60 ± 38.20) as compared to Group I (113.20 ± 35.79) and Group II (115.20 ± 38.41). The time of analgesic request in Group I was 148.16 ± 43.99 min, 190.60 ± 38.08 in Group II, and 200.80 ± 59.85 min in Group III.Conclusions:The addition of intrathecal clonidine 15 μg to small dose bupivacaine increased the spread, duration of analgesia, and produced effective spinal anesthesia with stable hemodynamics and did not prolong postoperative motor block.

Effect of adding various doses of clonidine as an adjunct in Transversus abdominis plane block in unilateral inguinal hernioplasty

Background: Transverses abdominis plane (TAP) block is a new regional anaesthetic technique for postoperative analgesia in abdominal surgeries, as a part of multimodal analgesia. We evaluated effect of two different doses of clonidine as an adjunct in TAP block in patients underwent unilateral inguinal hernioplasty.Methods: Sixty adult patients undergoing unilateral inguinal hernioplasty were randomized into two groups, Group A (n=30) received bilateral TAP block with bupivacaine 0.25% 38cc + clonidine (1cc) 150 microgram +1cc NS=40cc, Group B (n=30) received bupivacaine 0.25% 38cc+clonidine (2cc) 300 microgram=40cc, at the end of surgery. The postoperative pain was evaluated by visual analog score (VAS) for pain scoring at 2, 4, 6, 12 and at 24 hours. Subjective assessment of duration of analgesia was done.Results: The VAS score in patients who received clonidine 300 microgram Group B as an adjunct was significantly lower than who received 150 microgram Group A. Duration of analgesia was longer in Group B. 2 patients in Group B showed bradycardia treated with atropine. Sedation score was lesser in Group A.Conclusions: Clonidine showed dose dependant analgesia and adverse effect in TAP block for postoperative analgesia. Higher doses of clonidine may be used as an adjunct in TAP block.

A Comparative Study of Intrathecal Isobaric Ropivacaine with Different Doses of Clonidine in Lower Extremity Surgery

A Comparative Study of Intrathecal Isobaric Ropivacaine with Different Doses of Clonidine in Lower Extremity Surgery

Ntrathecal Hyperbaric Bupivacaine with Two Different Doses of Clonidine in Lower Limb Orthopaedic Surgery: A Comparative Study

ntrathecal Hyperbaric Bupivacaine with Two Different Doses of Clonidine in Lower Limb Orthopaedic Surgery: A Comparative Study

Comparison of Efficacy of Different Doses of Clonidine with 0.5% Bupivacaine for Spinal Anesthesia in Lower Limb Orthopedic Surgeries

ABSTRACTClonidine, a centrally acting α2 adrenergic agonist has been under use as an adjuvant with hyperbaric bupivacaine for prolonging analgesia and maintaining hemodynamic stability during lower limb orthopedic and lower abdominal surgeries.The purpose of our study was to compare the efficacy and safety of intrathecal Clonidine 50 and 75 μg as adjuvant to hyperbaric Bupivacaine 15 mg (3 mL), and hyperbaric Bupivacaine 3 mL with saline 0.5 mL for onset and duration of anesthesia, hemodynamic stability, and side effects if any.This prospective randomized controlled study was conducted on 120 patients scheduled for lower limb orthopedic surgeries under spinal anesthesia. The study population was divided into three groups with 40 patients in each group. Group I (controlled group) received 3 mL (15 mg) of 0.5% Bupivacaine heavy and 0.5 mL of normal saline. Group II received 50 μg of clonidine followed by Bupivacaine 0.5% 3 mL (15 mg) and group III received 75 μg of clonidine followed by Bupivacaine 0.5% 3 mL (15 mg) intrathecally. Time taken for onset of sensory and motor blockade, duration of anesthesia, and any perioperative and postoperative complications was noted.We found that clonidine 75 μg given prior to bupivacaine, 3 mL, significantly prolongs the duration of anesthesia with minimal changes in hemodynamic parameters and postoperative complications.How to cite this articleMurthy KTV, Nadkarni MD, Amaranath N. Comparison of Efficacy of Different Doses of Clonidine with 0.5% Bupivacaine for Spinal Anesthesia in Lower Limb Orthopedic Surgeries. J Med Sci 2017;3(2):45-49.

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

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 &#x03BC;g of clonidine (BC15 group) or 30 &#x03BC;g of clonidine (BC30 group) or 60 &#x03BC;g 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 &#x00B1; 120.30 vs. 422.06 &#x00B1; 112.47 and 376.21 &#x00B1; 87.21 minutes, respectively). Sedation was also more in BC 60 group. Conclusion: Intrathecal addition of 15 and 30 &#x03BC;g clonidine are better options when sedation is not desirable; on the contrary, addition of 60 &#x03BC;g provides excellent quality of spinal analgesia when some amount of sedation is acceptable or required without any deleterious effects on the mother and baby.

Comparison of Different Doses of Clonidine as an Adjuvant to Intrathecal Bupivacaine for Spinal Anaesthesia in Patients Undergoing Lower Limb Orthopedic Surgery

Background: Clonidine is added to local anaesthetics as adjuvant in spinal anaesthesia to improve quality and duration of sensory and motor block. Dose of Clonidine used is varied from 15μg to 150 μg and most of the studies are with low dose (8mg to 12mg) hyperbaric bupivacaine. Aim: Aim of this study was to evaluate and compare the effects of addition of three different doses of clonidine (15, 30 and 45 μg) to 18 mg hyperbaric bupivacaine in patients undergoing lower limb orthopedic surgery under spinal anaesthesia Study design: Prospective, randomized, double-blind, controlled study. Materials and Methods: 120 patients enrolled in the study were randomly divided into four groups of 30 each. Group I ,II, III,and IV received 0,15,30 and 45μg of clonidine respectively as an adjuvant to 18 mg hyperbaric bupivacaine. The volume of the solution was kept constant to 4 ml by adding normal saline. Results: The mean time for two segment regression, mean duration of sensory and motor block were higher in all the Clonidine groups. Mean arterial pressure was lower and vasopressor requirement was higher with an increase in the dose of Clonidine. Conclusion: To conclude, the addition of 15 μg of clonidine as an adjuvant to hyperbaric bupivacaine for spinal anaesthesia was found to be effective compared to 30 μg of clonidine, 45μg of clonidine as it causes significant prolongation of motor and sensory block duration without causing any hemodynamic derangements.

A Prospective Randomized Double Blind Study for Comparative Evaluation of Bupivacaine with Two Different Doses of Clonidine for Pediatric Caudal Analgesia in Infra Umbilical Surgeries

A Prospective Randomized Double Blind Study for Comparative Evaluation of Bupivacaine with Two Different Doses of Clonidine for Pediatric Caudal Analgesia in Infra Umbilical Surgeries

Optimization of Bupivacaine Induced Subarachnoid Block by Clonidine: Effect of Different Doses of Oral Clonidine

Background: Various drugs are used for premedication to reduce anxiety and to provide hemodynamic stability. The study was designed to investigate the optimum dose of oral clonidine administered preoperatively with regard to its anxiolytic efficacy and its effect on hemodynamics and sedation. We studied the effect of three different doses of oral clonidine on surgeries below umbilicus which were administered intrathecal bupivacaine. Methods: A placebo controlled double blind study was conducted on 120 patients scheduled for surgeries below umbilicus. Group 1 received oral placebo, group 2 received oral clonidine 3 μg kg-1, group 3 received oral clonidine 4 μg kg-1 and group 4 received oral clonidine 5 μg kg-1 along with 0.5% heavy bupivacaine 0.3 μg kg-1 intrathecally in each group. Outcomes assessed were anxiolysis through VAS, level of sensory block, time to reach highest sensory segment, regression to L1 segment, sedation score, bradycardia and hypotension. Results: There was improved block duration and sedation with the different doses of clonidine. Time for the sensory block to regress to L1 and rescue analgesia was longest in 4 followed by groups 3 and 2. There was significant dose dependent decrease in VAS anxiety score between group 1 and other clonidine groups in intraoperative and post-operative period. However, the episodes of bradycardia and hypotension were highest in 4 group. Conclusion: Preoperative oral clonidine 4 μg kg-1 appears to be the optimum dose for optimization of spinal anaesthesia with bupivacaine as it prolongs the sensory block maximally with minimal side effects.