Abstract Issue

Volume 12 Issue 2 ( April- June) 2023

Original Articles

Comparison of the dexmedetomidine and clonidine as an adjuvant to bupivacaine on duration of analgesia, motor and sensory blockade and the intraoperative hemodynamic profile of patients
Dr.Manas Karmakar, Dr. Ashok Das, Dr. Sankar Pal, Dr.Jatisankar Rudra

Background: The addition of clonidine or dexmedetomidine also allows for a reduction in the total dose of the local anaesthetic used, which translates into better hemodynamic stability in the intraoperative period. Clonidine and dexmedetomidine have also been shown to have significant analgesic affect in the post-operative period much after the regression of the motor blockade which allows for early and pain free ambulation. In the view of these facts, this study was planned to compare the effects of dexmedetomidine and clonidine on duration of analgesia, motor and sensory blockade and the intraoperative hemodynamic profile when used as an adjuvant to bupivacaine. Methods: This was a unicentric prospective study done in Department of Anaesthesiology, during February, 2012 to March, 2013 among the patients (age: 18-65 years) undergoing elective infra-umbilical surgery. Total sample size i.e. 90 patients were randomly divided into 3 groups of 30 patients each. Group B- received 2.6 ml of hyperbaric bupivacaine (13 mg) and 0.4 ml of normal saline, Group D- received 2.6 ml of hyperbaric bupivacaine (13 mg) and 5 μg of dexmedetomidine (0.05 ml) and 0.35 ml of normal saline and Group C- received 2.6 ml of hyperbaric bupivacaine (13 mg), 37.5 μg of clonidine (0.25ml) and 0.15 ml normal saline. A pretested proforma was used to collect the patients details such demographic, clinical parameters, Time to achieve sensory and motor blockade and adverse effects.Results: When compared with ANOVA age (p- 0.379), weight (p- 0.255), height (p- 0.063) and BMI (p- 0.062) were comparable between all groups with all insignificant p values. In our study, there was no fall or excess rise of heart rate in any group at any specific time period and mean heart rate in all groups were comparable over time. In our study the mean time to achieve T10 level sensory block in group-B was 5.73±1.46 minutes, in group-C was 5.93±1.33 minutes and in group-D was 6±1.49 minutes. The incidences of different side effects were low in the perioperative period upto a period of 24 hours and they were comparable between all the groups (p>0.05).Conclusion: Our conclusion from the study is that clonidine and dexmedetomidine as intrathecal adjuvant significantly prolongs the sensory and motor blockade of intrathecal hyperbaric bupivacaine without altering the onset of spinal anaesthesia.

 
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