Comparison of intrathecal clonidine and dexmedetomidine as adjuvant to bupivacaine for hemodynamic response and postoperative analgesia in infraumbilical surgeries

Introduction: Various adjuvants have been added to bupivacaine to shorten the onset of block and prolong the duration of block. Present study was undertaken to compare the efficacy of intrathecal clonidine or buprenorphine with bupivacaine in lower abdominal surgeries. Methods: 90 ASA I and II patients undergoing lower abdominal surgeries were randomly allocated into three groups(n=30). Group A received 3ml of 0.5% hyperbaric bupivacaine with 1ml normal saline, Group B received 3ml of 0.5% hyperbaric bupivacaine with 60 mcg buprenorphine(1:5 dilution) and Group C received 3ml of 0.5% hyperbaric bupivacaine with 30mcg clonidine(1:5 dilution) respectively (Total volume 4ml). Onset time and duration of sensory and motor block, duration of analgesia, hemodynamics, VAS score, sedation score and side effect were compared. Results: The duration of analgesia was significantly longest in Group C (354.50±38.48min), followed by Group B (277.10±25.47min) and Group A(131.50±20.15min) (p<0.001) Conclusion: Clonidine(30mcg) and buprenorphine(60mcg) when used as adjuvants to 0.5% hyperbaric bupivacaine intrathecally produces significantly longer duration and better quality of postoperative analgesia than bupivacaine alone. On comparing the two drugs, Clonidine appears to be superior in terms of postoperative analgesia. Keywords: clonidine, buprenorphine, intrathecal, postoperative analgesia.

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Intrathecal Clonidine Added to a Bupivacaine-Morphine Spinal Anesthetic Improves Postoperative Analgesia for Total Knee Arthroplasty

Anesthesia & Analgesia ◽

10.1213/01.ane.0000055651.24073.59 ◽

2003 ◽

pp. 1083-1088 ◽

Cited By ~ 50

Author(s):

Brian D. Sites ◽

Michael Beach ◽

Russell Biggs ◽

Christopher Rohan ◽

Christopher Wiley ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Postoperative Analgesia ◽

Spinal Anesthetic ◽

Total Knee ◽

Intrathecal Clonidine

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Intrathecal clonidine added to small-dose bupivacaine prolongs

Canadian Urological Association Journal ◽

10.5489/cuaj.325 ◽

2013 ◽

Vol 6 (1) ◽

pp. 25

Author(s):

Agreta Gecaj-Gashi ◽

Hasime Terziqi ◽

Tune Pervorfi ◽

Arben Kryeziu

Keyword(s):

Spinal Anesthesia ◽

Postoperative Analgesia ◽

Motor Block ◽

Sensory Block ◽

Analgesia Requirement ◽

American Society ◽

Group B ◽

Double Blinded ◽

Intrathecal Clonidine ◽

American Society Of Anesthesiologists

Introduction: The aim of this prospective, double-blinded studywas to investigate the effects of clonidine in co-administrationwith bupivacaine during spinal anesthesia, regarding the onset and regression of motor and sensory block, postoperative analgesia and possible side effects.Methods: We randomly selected 66 male patients (age 35 to 70), from the American Society of Anesthesiologists (ASA) class I-II; these patients were scheduled for transurethral surgical procedures. These patients were randomly allocated into two groups of 33 patients each: group B (bupivacaine) only received 0.5% isobaric bupivacaine 7.5 mg intrathecally and group BC (bupivacaine + clonidine) received bupivacaine 7.5 mg and clonidine 25 μg intrathecally. We performed the spinal anesthesia at a level of L3-L4 with a 25-gauge needle. We assessed the sensory block with a pinprick,the motor block using the Bromage scale, analgesia with thevisual analog scale and sedation with the modified Wilson scale.We also recorded the hemodynamic and respiratory parameters.Results: The groups were demographically similar. The mean time of achievement of moto block (Bromage 3) and sensory block at level T9 was significantly shorter in the BC group compared with B group (p = 0.002, p = 0.000, respeectively). The motor block regression time was not significantly different between the two groups (p = 0.237). The postoperative analgesia requirement was significantly longer in group BC compared with group B (p = 0.000). No neurological deficit, sedation or other significant adverse effects were recorded.Conclusion: The intrathecal application of clonidine in combination with bupivacaine improves the duration and quality of spinal anesthesia; it also provides longer duration of postoperative analgesia, without significant side effects.

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