A COMPARATIVE STUDY OF INTRATHECAL DEXMEDETOMIDINE AND CLONIDINE AS AN ADJUVANT TO INTRATHECAL BUPIVACAINE IN ELECTIVE LOWER LIMB SURGERIES

DR S.LEO; DR. SANKARA GANAPATHY

Volume : VIII, Issue : V, May - 2018

A COMPARATIVE STUDY OF INTRATHECAL DEXMEDETOMIDINE AND CLONIDINE AS AN ADJUVANT TO INTRATHECAL BUPIVACAINE IN ELECTIVE LOWER LIMB SURGERIES

Dr S. Leo, Dr. Sankara Ganapathy

Abstract :

Background and Aims

To evaluate and compare intrathecalDexmedetomidine and intrathecal Clonidine as an adjuvant to 0.5% hyperbaric bupivacaine for lower limb surgeries, with respect to block characteristics, efficacy, haemodynamic changes&adverse effects.

Materials and Methods:Ninety patients in the age group between 20 and 60 years of either sex belonging to ASA Grade I–II posted for elective lower limb surgeries were divided randomly into three groups (n=30).Group B: received 15mg of 0.5% hyperbaricbupivacaine with 0.5ml normal saline.GroupC:received 15mg of 0.5% hyperbaricbupivacaine with 50µg Clonidine. GroupD:received 15mg of0.5% hyperbaric bupivacaine with 5µg Dexmedetomidine.The quality of block,total duration of analgesia,hemodynamic stability and side effects of the study drugs were recorded.

Results:

The mean time of onset of sensory blockade was shorter ingroup C (1.4±0.5mins) and group D (1.17±0.37mins) than group B (2.8 ± 0.66 mins). Two dermatomalregression time was longer in both Group C(136.33±10.9 mins)and D (136.33±10.9 mins)when compared to Group B(79.46±10.16mins).The mean duration of analgesia was 191±22.94mins, 342.33±28.12 mins and 369.33±34.13 mins in group B, group C and group D respectively.

The mean time taken for the onset of motor blockade was 4.00±0.69mins, 1.63±0.49 mins and 1.13±0.346 mins in group B, group C and group D respectively. The mean time taken for attaining maximum motor blockade in Groups B,C & D was 6.57±0.93, 6.43±1.045 and 5.20±0.887mins. The mean duration of motor blockade was 166.16±20.95, 279±24.68 and 303.66±35.95 minsin group B, group C and group D respectively.The mean sedation score was 0.4±0.49 in group B, 0.50±0.682 in group C and 0.53±0.681 in group D.

Conclusion

IntrathecaldexmedetomidineOr intrathecal clonidine,when added as adjuvants with 15mg 0.5% hyperbaric bupivacainethey decrease the onset time,increase theduration of sensory &motor blockadeand provide good postoperative analgesia.