Comparison of intrathecal clonidine and dexmedetomidine as adjuvant to bupivacaine for hemodynamic response and postoperative analgesia in infraumbilical surgeries
Journal Title: Medpulse International Journal of Anesthesiology - Year 2019, Vol 9, Issue 2
Abstract
Background: Clonidine and Dexmedetomidine is commonly used adjuncts with hyperbaric Bupivacaine in spinal anaesthesia. Both are α2 adrenergic agoinsts. Dexmedetomidine is comparatively newer drug with lesser side effects. Though both drugs were used commonly their effectiveness in subarachnoid block remains a debate. Aim of the study is to compare the Postoperative Analgesia and Heamodynamic response to intrathecal Clonidine and Dexmedetomidine as adjuvant to Bupivacaine in infraumbilical surgeries. Method: 60 patients of ASA 1 and 2 between age groups undergoing infraumbilical surgeries under spinal anaesthesia were selected and randomly allocated into 2 groups. Group D received 3 ml Bupivacaine heavy and 3 µg Dexmedetomidine. Group C received 3 ml Bupivacaine heavy and 30 µg Clonidine. Constant drug solution volume of 3.3ml was injected at L3-L4 space intrathecally. Onset and duration of sensory and motor block, duration of effective analgesia, heamodynamic changes and side effects were recorded. Result: Onset of sensory block was 3.34min in Group D and 4.032min in Group C. Onset of motor block was 3.2min in Group C and 3.8 min in Group D. Duration of sensory block was 337.98 min in group D and 265.46 min in group C. Duration of motor block measured was 262.42 min in group D and 205.8 min in group C. Rapid onset and prolonged duration of sensory and motor block was seen in group D compared to group C. Two segmental regression was 99.54 min in Group C and 136.54 min in Group C. Duration of analgesia was 305.7min in Group C and Group D was 366.4min.Two segmental regression and Duration of analgesia was prolonged in Group D. Both Dexmedetomidine and Clonidine decreased vitals, PR, SBP, DBP but were comparable. Clonidine produced more sustained and prolonged hypotension with lesser plane of sedation when compared to Dexmedetomidine. Conclusion: Intrathecal Dexmedetomidine 3 µg added as additive with intrathecal Bupivacaine proved to be better than 30 µg Clonidine.
Authors and Affiliations
Antony Paulson, Anand B, Selvakumaran Pannirselvam, U G Thirumaaran
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