scholarly journals A comparative study of efficacy of oral pregabalin and clonidine for attenuation of pressor response to intubation

2021 ◽  
Vol 10 (9) ◽  
pp. 1095
Author(s):  
Haramritpal Kaur ◽  
Jatin Gupta ◽  
Amandeep Singh ◽  
Gurpreet Singh ◽  
Anshul Dahuja ◽  
...  
Keyword(s):  
Endotracheal Intubation ◽  
Stress Responses ◽  
Pressor Response ◽  
Hemodynamic Parameters ◽  
Time Intervals ◽  
The Past ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Oral Premedication

Background: Endotracheal intubation is associated with hemodynamic stress responses. Various drugs have been used in the past to attenuate the pressor response; however, none has been proved to be ideal. Present study was planned to evaluate the oral pregabalin 150 mg and clonidine 200 µg for attenuation of pressor response to intubation.Methods: The study was conducted on 100 adult patients of either gender scheduled to undergo elective surgeries under general anaesthesia (GA). The patients were randomly allocated into 2 groups. In group A patients received pregabalin 150mg and in group B patients received clonidine 200µg orally. The hemodynamic parameters were recorded until 10 minutes after intubation. The sedation, anxiety and side effects were also assessed.Results: In clonidine group, the mean HR remained below the baseline value at all the time intervals. In pregabalin group, the mean HR remained below the baseline value at most of the time intervals but increased above baseline just after intubation (T0i) and 1 minute after intubation (T1i) where increase was only 1.488±1.20% and 0.45±1.16% respectively from baseline. In both pregabalin and clonidine groups, the mean SBP and MAP remained below the baseline value (Tb) at all the time intervals from T0.5 to T10i. Both clonidine and pregabalin provided adequate anxiolysis and sedation with pregabalin providing more pronounced sedation and anxiolysis than clonidine.Conclusions: Both clonidine and pregabalin are effective oral premedication drugs for attenuation of the pressor response to laryngoscopy and endotracheal intubation.  

scholarly journals In Vivo Study on Site of Action of Sinapine Thiocyanate following Acupoint Herbal Patching

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Shan Chen ◽  
Yu-Tong Jin ◽  
Zheng-Yang Zhu ◽  
Ling-Tao Wu ◽  
Ping Yang ◽  
...  
Keyword(s):  
Mass Spectrometry ◽  
Wistar Rats ◽  
Pharmacokinetic Profile ◽  
Time Intervals ◽  
Site Of Action ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Group D

Objective. To investigate the site of action of sinapine thiocyanate (ST), following acupoint herbal patching (AHP). Methods. Twenty Wistar rats were randomized into five groups (groups A, B, C, D, and E), and all groups received the same AHP in vivo. Skin samples were excised at 2 h, 4 h, 6 h, 10 h, and 26 h after AHP administration from group A to group E separately and the concentrations of ST in the skin were determined using a liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS) method. A pharmacokinetic profile of ST following AHP was performed at the same time in a group of five Wistar rats to detect plasma levels at the same time intervals. Results. The mean ± SD ST concentrations (ng/ml) at 2 h (group A), 4 h (group B), 6 h (group C), 10 h (group D), and 26 h (group E) after AHP administration were 250.01±61.99, 61.01±30.41, 40.12±26.94, 78.66±59.43, and 19.55±18.95, respectively. No ST was detected in rats’ plasma samples at the same time points. Conclusions. The site of action of ST following AHP is in the skin.

scholarly journals Efficacy of Different Doses of Dexmedetomidine in Blood Pressure to Laryngoscopy in Controlled Hypertensive Patient: A Randomized Control Trial

2021 ◽  
Vol 48 (3) ◽  
pp. 1-8
Author(s):  
Rumana Afroz ◽  
Rabeya Begum ◽  
Shafiqul Alam ◽  
Md Nurul Islam ◽  
Mahin Muntakim ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Hypertensive Patient ◽  
Endotracheal Intubation ◽  
Normal Saline ◽  
Blood Pressure Monitor ◽  
Pressure Monitor ◽  
Evaluation Period ◽  
Group A ◽  
The Mean ◽  
Group B

Control of blood pressure during anesthesia is very crucial. Laryngoscopic manipulation and endotracheal intubation are always a matter of concern which capable of producing tachycardia, arrhythmias and hypertension which is generally well tolerated in healthy patient. In hypertensive patient cardiovascular response to laryngoscopy and intubation is exaggerated.  This study was conducted to assess the efficacy of different doses of dexmedetomidine in reduction of blood pressure during laryngoscopy and intubation in controlled hypertensive patient. This prospective Randomized controlled trial was carried out among 60 patients belonging to American Society of Anesthesiologists (ASA) Physical Status II posted for elective general anesthesia. Patients were randomly divided into three groups where each groups contain twenty with fixed card sampling. Group A consisted of twenty (20) patients who were received IV dexmedetomidine 0.5 µg/kg diluted to 50 ml with normal saline.  Group B consisted of twenty (20) patients who were received IV dexmedetomidine 0.75 µg/kg diluted to 50 ml with normal saline. Group C consisted of twenty (20) patients who were received IV dexmedetomidine 1 µg/kg diluted to 50 ml with normal saline. Each infusions were started 10 minutes prior induction of general anesthesia and were given over 10 minutes. Baseline systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial blood pressure (MAP) were measured by one volunteer anesthesiologists by non-invasive blood pressure monitor. Following laryngoscopy and endotracheal intubation, the parameters recorded were SBP, DBP and MAP at 1, 3 and 5 min after intubation by non-invasive blood pressure monitor. The primary outcome measures were blood pressure responses after intubation and secondary outcome measures were to note down any adverse effects associated with drugs.  In this study baseline readings of SBP, DBP and MAP were almost similar in all three groups and statistically not significant. Maximum intubation response was seen at 1 min post intubation in all the three groups. The mean SBP of group A varied from 144.8±8.4 mmHg to 118.5±4.4 mmHg that of group B varied from 134.8±4.1 to 122.0±4.2 mmHg and then group C varied from 126.5±15.5 mmHg to 103.8±8.4 mmHg during different evaluation period (p<0.05). The mean DBP of group A varied from 91.8±7.6 mmHg to 72.4±5.8 mmHg that of group B varied from 81.3±5.2 to 70.3±2.5 mmHg and then group C varied from 80.9±6.7 mmHg to 63.4±2.4 mmHg during different evaluation period (p<0.05). The mean MAP of group A varied from 109.0±5.6 mmHg to 87.5±4.4 mmHg that of group B varied from 98.7±2.5 to 86.3±3.4 mmHg and then group C varied from 95.5±9.2 mmHg to 76.5±3.4 mmHg during different evaluation period (p<0.05). The mean SBP at 1st hour was found 127.9±6.5 in group A, 131.6±6.4 group B and 131.5±7.1 group C. The DBP at 1st hour was found 126.8±6.4 in Group A, 131.4±6.8 in Group B and 131.8±6.1 in Group C. The mean MAP at 1st hours was found 93.2±3.7 in group A, 95.4±3.4 in Group B and 96.2±4.9 in Group C(p>0.05). Dexmedetomidine in doses of 0.75 µg/kg was more effective compared to 0.05 µg/kg and 1µg/kg in attenuating blood pressure response to laryngoscopy and endotracheal intubation without producing adverse effects in control hypertensive patients. Bangladesh Med J. 2019 Sep; 48 (3): 1-8

scholarly journals Hemodynamic and Bispectral Changes During Pin Insertion in Craniotomy – Effect of Locally Infiltrated Bupivacaine

PRILOZI ◽  
2017 ◽  
Vol 38 (2) ◽  
pp. 115-121
Author(s):  
Vesna Durnev ◽  
Marija Soljakova ◽  
Venko Filipce ◽  
Maja Mojsova Mijovska ◽  
Marina Temelkovska Stevanovska
Keyword(s):  
Blood Pressure ◽  
Intracranial Pressure ◽  
Hemodynamic Parameters ◽  
Time Intervals ◽  
Head Stabilization ◽  
Significant Difference ◽  
The Mean ◽  
The Difference ◽  
Group B ◽  
Scalp Incision

Abstract Introduction Cranial pins insertion is a method for head stabilization and together with the scalp incision is one of the biggest noxious stimulus associated with arousal and rapid increase of the blood pressure leading to pathological increase of the intracranial pressure. The aim of this investigation is to study the superiority of the locally infiltrated anesthetic bupivacaine just before the skull pin insertion and the scalp incision in craniotomy under general anesthesia. Methods In the study thirty patients of both genders aged 24-72 years were included. They were categorized as ASA 1 and 2 and divided into two group of 15 patients each, group B (bupivacaine) and group S (saline). We recorded the bispectral (BIS) index, the mean arterial pressure (MAP) and the pulse rate (PR) in five time intervals: t 0-2 min before pin insertion; t 1-2 min after pin insertion; t 2-5 min after; t 3-10 min after and t 4-15 min after. Results Significant difference p<0.05 was achieved in group S for all three followed parameters: blood pressure, heart rate and bispectral index. The difference is present in all four time intervals compared to the initial one before the pin insertion. With further analysis it was demonstrated that the investigated BIS index participates the most in the overall significance in group F. Conclusion The scalp infiltration with local anesthetic bupivacaine results with stable hemodynamic parameters and stable intracranial pressure during the painful procedures as craniotomy.

“A COMPARATIVE STUDY OF HEMODYNAMIC RESPONSE FOLLOWING LARYNGOSCOPY AND ENDOTRACHEAL INTUBATION: DIRECT VERSUS VIDEO LARYNGOSCOPY”

2021 ◽  
pp. 15-17
Author(s):  
Ankit Shrivastava ◽  
Devashri Chilke ◽  
Nishant Kumar ◽  
Debarshi Jana
Keyword(s):  
Blood Pressure ◽  
General Anaesthesia ◽  
Endotracheal Intubation ◽  
Video Laryngoscope ◽  
Intubation Time ◽  
Hemodynamic Responses ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Mean Time

Introduction: Laryngoscopy and endotracheal intubation are the two essential procedures when general anaesthesia is administered to a patient. Adverse responses in the cardiovascular, respiratory, and other physiological systems can be provoked due to the noxious stimuli produced by laryngoscopy and intubation.1 During general anaesthesia maintenance of airway and ventilation can be done in various ways. Aims & Objectives: To assess the superiority of video laryngoscopy over direct laryngoscopy using baseline parameters like heart rate, systolic blood pressure, diastolic blood pressure and mean blood pressure. Materials And Methods: Interventional, Randomized study. Operation theatre of Durgapur Steel Plant Hospital, Durgapur, West Bengal. Adult males and females, ASA physical Grade 1 and 2 patients, scheduled for elective surgeries, under General Anesthesia, requiring or tracheal intubation. 1 year. From February 2018 to February 2019. Result And Analysis:In Group-A (MDL), 28(56.0%) patients had MPG 1 and 22(44.0%) patients had MPG 2. In Group-B (KVVL), 29(58.0%) patients had MPG 1 and 21(42.0%) patients had MPG 2. Association of MPG vs. group was not statistically signicant (p=0.8399). In Group-A (MDL), the mean time taken for intubation (mean±s.d.) of patients was 34.5600 ± 2.3661. In Group-B (KVVL), the mean time taken for intubation (mean±s.d.) of patients was 20.4000 ± 1.7728. Distribution of mean time taken for intubation vs. group was statistically signicant (p<0.0001). Conclusion: Also, Kingvision video laryngoscope offered less intubation time and reduced hemodynamic responses in patients with ASA grade 1and 2 as compared to Macintosh laryngoscope. So further study can be done on patients with difcult airways (III-IV) and with different co morbidities (ASA 3,4, E) to evaluate whether using Kingvision video laryngoscope can be advantageous in reducing intubation time and obtunding hemodynamic responses to laryngoscopy and intubation.

Intraocular pressure response to airway management: Comparison between LMA Supreme® and C-MAC® videolaryngoscope in day care surgery

2020 ◽  
Vol 24 (6) ◽  
Author(s):  
Haramritpal Kaur ◽  
Gurpreet Singh ◽  
Jaipreet Singh ◽  
Munish Dhawan ◽  
Amandeep Singh ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Airway Management ◽  
Endotracheal Intubation ◽  
Day Care ◽  
Hemodynamic Parameters ◽  
Day Care Surgery ◽  
Group A ◽  
Lma Supreme ◽  
Group B ◽  
Care Surgery

Background: Airway maintenance procedures during anesthesia are usually associated with a rise in intraocular pressure (IOP). This is an important issue especially in vulnerable patients. In the present study we compared the rise in IOP with two different group of airway devices i.e. Laryngeal mask airway Supreme (LMA-S) and endotracheal intubation (ETT) using C-MAC® videolaryngoscope (VLS). Methodology: The present study was conducted on 100 adult patients of ages >18 yrs, of either sex, belonging to American Society of Anesthesiologist (ASA) I and II, scheduled to undergo non-ophthalmic elective surgery under general anesthesia. Patients were divided into two equal groups of 50 each, Group A and Group B. In group A (n = 50), lubricated appropriate sized LMA-S was inserted and in Group B (n=50), lubricated appropriate sized ETT was inserted by an anesthesiologist using VLS. IOP was measured in right eye just before insertion of device and subsequently at 1 min, 3 min, 5 min and 10 min after insertion of device. Hemodynamic parameters were recorded along with IOP measurement. Results: Both the groups were comparable regarding demographic data (p > 0.05), ASA grade (p = 0.069), and Mallampati grade (MPG) (p = 0.646). Airway establishment time (p = 0.011) was significantly less with C-MAC VLS. IOP were comparable at all measurement times, e.g., 1 min (p = 0.216), 3 min (p = 0.093), 5 min (p = 0.859) and 10 min (p = 0.060) after insertion of each device. Hemodynamic parameters measured were also comparable between two groups (p > 0.05). Conclusion: Both LMA Supreme and intubation using C-MAC® videolaryngoscope are safe regarding rise in intraocular pressure. Both methods can be safely used for airway management in suitable patients. Key words: Airway; Anesthesia; Intraocular pressure; LMA; Endotracheal intubation Citation: Kaur H, Singh G, Singh J, Kaur, Dhawan M, Singh A. Intraocular pressure response to airway management: Comparison between LMA Supreme and C-MAC® videolaryngoscope in day care surgery. Anaesth. pain intensive care 2020;24(6):__ Received: 27 January 2020, Revised: 12 May 2020, Reviewed: 25 October 2020, Accepted: 27 October 2020

scholarly journals Role of intravenous esmolol, fentanyl and lignocaine for attenuation of stress response in tracheal intubation - a comparative study

2014 ◽  
Vol 26 (1) ◽  
pp. 12-19
Author(s):  
Nurul Islam ◽  
Amirul Islam ◽  
Idris Ali ◽  
Mohiuddin Shumon ◽  
Mozaffor Hossain ◽  
...  
Keyword(s):  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Endotracheal Intubation ◽  
Haemodynamic Response ◽  
Rate Pressure Product ◽  
Mean Values ◽  
Group A ◽  
The Mean ◽  
Group B

Background Endotracheal intubation is an essential part of safe airway management but this stimulates the patient’s airway reflexes and predictably leads to haemodynamic derangement. Many drugs have been suggested in modifying in haemodynamic responses to laryngoscopy and intubation. Objectives To assess efficacy of three drugs - esmolol, fentanyl and lignocaine and to assess which one is more effective to attenuate haemodynamic response to direct laryngoscopy and endotracheal intubation. Methods A total number of 90 patients ASA class I and II were selected randomly as per inclusion and exclusion criteria in three groups, 30 patients in each group. Group A received esmolol 1.5mg/kg in the volume of 10ml (with distil water) 2min before intubation, group B received fentanyl 1.5mg/kg IV 5min before intubation and group C received lignocaine 1.5mg/kg IV 90 sec before intubation. Per-operative data were recorded at 1min, 2min, 5min and 10min after intubation. Results The mean heart rate, systolic, diastolic,mean arterial pressure before starting anaesthesia were similar in group-A (esmolol), B(fentanyl) and C(lignocaine). The mean values of heart rate and rate pressure product were significantly lower in group A(Esmolol) at 1 and 2 minute than group B(fentanyl) and at 1, 2 and 5 minute than group C(lignocaine). The mean values of systolic, diastolic and mean arterial pressure were slightly lower in group A(esmolol) at 5 minute than group B(fentanyl) and significantly lower at 1, 2 and 5 minute than group C(lignocaine). Conclusion Esmolol 1.5mg/kg is superior to lignocaine 1.5mg/kg for attenuation of haemodynamic response (HR, SBP, DBP, RPP and MAP) to laryngoscopy and endotracheal intubation and also superior to fentanyl for attenuation of HR and RPP. DOI: http://dx.doi.org/10.3329/jbsa.v26i1.19810 Journal of Bangladesh Society of Anaesthesiologists 2013; 26(1): 12-19  

COMPARATIVE STUDY OF FLUCTUATIONS IN HEMODYNAMIC PARAMETERS USING DIFFERENT INTRA-ABDOMINAL PRESSURES IN LAPAROSCOPIC CHOLECYSTECTOMY

2021 ◽  
pp. 27-29
Author(s):  
Challa Karunasree ◽  
Devashri Chilke ◽  
Arunima Dutta ◽  
Debarshi Jana
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Surgical Intervention ◽  
Open Cholecystectomy ◽  
Hemodynamic Changes ◽  
Time Intervals ◽  
Vas Score ◽  
Group A ◽  
Vas Scores ◽  
The Mean ◽  
Group B

INTRODUCTION: Laparoscopic cholecystectomy decreases postoperative pain, decreases the need for postoperative analgesia, returns the patient to full activity within 1 week (compared with 1 month after open cholecystectomy), discharged the day after surgery. This study was conducted to compare the uctuations in hemodynamic changes using different intra- abdominal pressures with CO2 in laparoscopic cholecystectomy. MATERIALS AND METHODS: Thisrandomised, prospective, interventional study was conducted in Durgapur Steel Plant Hospital, Durgapur, West Bengal from November 2018 to January 2020. In our study, we attempted to compare the uctuations in hemodynamic changes using different intra- abdominal pressures. Present study included 90 cases undergoing laparoscopic cholecystectomy who were randomly divided into 3 groups with different intra-abdominal pressures, maintained during surgical intervention by CO2 insufation. RESULT: Mean VAS score was 2.83 in group Aafter 6 hours of laparoscopic cholecystectomy which decreased to 2.13 and 0.07 by the end of 12 and 24 hours respectively. The mean VAS scores for group B and C were 5.87; 8.03, 4.33; 7.10 and 2.40; 5.93 at 6, 12 and 24 hours post laparoscopic cholecystectomy respectively. Mean VAS score was signicantly lower in group A as compared to group B and lower in group B as compared to group C respectively at all time intervals (p<0.01). CONCLUSION: Low intra-abdominal pressures during surgical intervention by CO2 insufation leads to better hemodynamic control, better pain management and decreased hospital stay. Present study thus recommends use of low pressure pneumoperitoneum in all cases undergoing laparoscopic cholecystectomy.

scholarly journals Effect of Supraperiosteal Injection of Dexamethasone on Interappointment Pain in Teeth with Symptomatic Irreversible Pulpitis: A Comparative Study

2020 ◽  
Vol 1 (4) ◽  
pp. 4
Author(s):  
Lt Col Ajmal Yousaf ◽  
Fatima Ali ◽  
Syed Muzammil Hussain ◽  
Faisal Bhangar ◽  
Nasrin Yousaf ◽  
...  
Keyword(s):  
Random Number ◽  
Sampling Technique ◽  
Armed Forces ◽  
Time Intervals ◽  
Group A ◽  
Random Number Table ◽  
The Mean ◽  
Group B ◽  
Irreversible Pulpitis ◽  
Scale Data

Objective: To compare the effect of supraperiosteal injection of dexamethasone with 2% lidocaine on the frequency of interappointment endodontic pain at different time intervals. Study Design: Prospectivecomparativestudy. Place and Duration of Study: The study was carried out at operative department of Armed Forces Institute of Dentistry, Rawalpindi from 1st October 2019 to 31st March 2020. Materials and Methods: A total of 100 patients presenting to the Department of Operative Dentistry, Armed Forces Institute of Dentistry, Rawalpindi and giving consent for participation, aged 20-50 years from both genders, presenting with acutely inflamed pulp in their maxillary first molars were selected for this study using convenient sampling technique. The patients were randomly divided into two equal groups of 50 patients with the help of scientific random number table. Endodontic therapy was initiated, pulpectomy canals were prepared with ProTaper Next system, intra-canal dressings of calcium hydroxide were placed and the cavity was restored with Cavit till the next appointment. Group A patients were then injected with dexamethasone at the mucobuccal fold and group B patients were injected with lidocaine used as placebo. Pain was recorded at 48 and 72 hours using the visual analogue scale. Data was analyzed using SPSS 21. Results: The study included equal number of male and females. The mean age of group A was 35 ± 4.5 years while of group B was 33 ± 6.7 years. The results showed that dexamethasone does not reduce pain at 48 and 72 hours compared to the placebo. Conclusion: It is concluded that dexamethasone does not reduce interappointment endodontic pain when compared to a placebo.

scholarly journals A COMPARATIVE STUDY OF ORAL CLONIDINE VERSUS ORAL PREGABALIN ON HEMODYNAMIC RESPONSES TO LARYNGOSCOPY AND ENDOTRACHEAL INTUBATION UNDER GENERAL ANAESTESIA

2019 ◽  
Vol 3 (4) ◽  
Author(s):  
Pratibha Rathore ◽  
Varsha Saini ◽  
Fareed Ahmed ◽  
Rama Chatterjee ◽  
Monika Rathore
Keyword(s):  
Blood Pressure ◽  
Endotracheal Intubation ◽  
Sympathetic Activity ◽  
Elective Surgery ◽  
Pressor Response ◽  
Hemodynamic Changes ◽  
Oral Clonidine ◽  
Group A ◽  
Group B ◽  
Better Than

Background: Laryngoscopy and endotracheal intubation are potent stimuli that can induce increased sympathetic activity leading to tachycardia, hypertension and dysrrhythmias. Various drugs and methods have been tried to obtund this response. To obtain ideal drugs, studies still continue. We compared the efficacy of clonidine and pregabalin to attenuate the pressor response during laryngoscopy and intubation. Method: Total 80 patients of ASA grade I scheduled for elective surgery under general anaesthesia, were randomized into two groups. Group A received oral clonidine 300 mcg 2 hrs prior to surgery, group B received oral pregabalin 75mg 2 hrs prior to surgery. Heart rate and blood pressure (SBP, DBP &MAP) were recorded at baseline, before induction, before intubation, during laryngoscopy, 0, 1, 3, 5, and 10 minutes after intubation. Results: When compared to clonidine and pregabalin, there was a significant increase in HR and MAP in pregabalin after laryngoscopy and tracheal intubation. Clonidine was better than pregabalin in suppressing the pressor response. Conclusion: Clonidine appears to be better than Pregabalin for control of haemodynamic response to laryngoscopy and intubation besides providing sedation. Keywords: Clonidine, Pregabalin, hemodynamic changes and endotracheal intubation.

scholarly journals A comparative study of dexmedetomidine versus clonidine in epidural anaesthesia to assess the level of sedation in patients undergoing lower abdominal and lower limb surgery

2018 ◽  
Vol 6 (5) ◽  
pp. 1666
Author(s):  
Vinay Pathak ◽  
B. B. Kushwaha ◽  
Girish Chandra ◽  
V. K. Bhatia ◽  
Akash Gupta ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Normal Saline ◽  
Lower Limb ◽  
Saline Group ◽  
Hemodynamic Parameters ◽  
Normal Saline Group ◽  
Time Intervals ◽  
Group A ◽  
Group B

Background: To compare study of dexmedetomidine versus clonidine in epidural anesthesia to assess the level of sedation in patients undergoing lower abdominal and lower limb surgery.Methods: This was a comparative study conducted on admitted ASA grade I and II patients undergoing lower abdominal and lower limb surgeries. The patients were divided into three groups of 30 patients each, according to the epidural medication they received:-Group A-received 15ml of bupivacaine (0.5%) and dexmedetomidine (1.0µg/kg body weight) in 1ml of normal saline; Group B-received 15ml of bupivacaine (0.5%) and clonidine (2.0µg/kg body weight) in 1ml of normal saline; Group C-received 15ml of bupivacaine (0.5%) with 1ml of normal saline. The heart rate, blood pressure, sensory dermatome level, Motor blocked level, pain and VAS were recorded at different time intervals. The side effects were also noted.Results: The baseline parameters were comparable among the groups. All the hemodynamic parameters and other study parameters were similar at Min. 0. All the hemodynamic parameters such as heart rate, blood pressure and SpO2 were variable at different time intervals. Motor block level   was significantly (p<0.05) lower in Group C than Group A and Group B from Min 50 to Min 90. The sedation score was observed to be nil in Group C. The post-op pain score became higher in Group C than Group A and Group B at subsequent time intervals. A 3 (10%) of the rescue agents was observed in Group C. Atropine (30%) and mephenteramine (10%) were common rescue agents in Group B. The bradycardia was observed in 30% patients of Group B and in 40% of Group A.Conclusions: On addition of dexmedetomidine as adjuvant to bupivacaine in epidural anesthesia provides better anesthesia and sedation than clonidine as adjuvant to bupivacaine or bupivacaine alone with mild hemodynamic changes which are easily manageable.

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