COMPARISON OF EFFECT OF INTRATHECAL BUPRENORPHINE VERSUS CLONIDINE AS ADJUVANT TO 0.5% BUPIVACAINE IN LOWER LIMB SURGERIES.

DR.K.ANITHA; DR.S.A.VARA PRASAD

Volume : VII, Issue : XI, November - 2017

COMPARISON OF EFFECT OF INTRATHECAL BUPRENORPHINE VERSUS CLONIDINE AS ADJUVANT TO 0.5% BUPIVACAINE IN LOWER LIMB SURGERIES.

Dr. K. Anitha, Dr. S. A. Vara Prasad

Abstract :

Background and aims: There are very few reported clinical trials with direct comparison of buprenorphine and clonidine on subarachnoid block characteristics. The aim of the present study was to compare the effect of buprenorphine 75 μg and clonidine 50 μg as an adjuvant to 15 mg of 0.5% bupivacaine in lower limb surgeries with respect to the subarachnoid block characteristics, postoperative analgesia and side–effects.

Methods: One hundred patients of 18 to 60 years, either sex and American Society of Anesthesiologist (ASA) I/II undergoing elective lower limb surgeries under planned spinal anesthesia were included and randomly allocated into two equal groups (n = 50 each) to receive intrathecal 0.5% bupivacaine (heavy) with either clonidine 50 μg (group C) or buprenorphine 75 μg (group B) . The patients were evaluated with respect to various sensory and motor block characteristics, duration of postoperative analgesia and adverse effects.

Result: Both the groups were comparable with respect to demographic profile. There was significant prolongation in the duration of sensory block (119.26 ± 24.56 vs 79.40 ± 15.67; p = 0.0), motor block (277.90 ± 37.56 vs 198.80 ± 42.21; p = 0.0) and postoperative analgesia (355.80 ± 63.85 vs 283.20 ± 51.84; p = 0.0) in group C compared with group B. There was clinically significant earlier onset of maximum sensory block (9.20 ± 5.69 vs 11.90 ± 4.78; p = 0.018) and motor block (5.10 ± 3.39 vs 11.90 ± 4.78; p = 0.018) in group C compared with group B however the results were statistically significant only for time to attain maximum sensory block. The incidence of shivering was

significantly lower in group C compared with group B.

Conclusion: Intrathecal 50 μg clonidine seems to be an attractive alternative to 75 μg buprenorphine as an adjuvant to spinal bupivacaine in terms of duration of sensory and motor blockade, postoperative analgesia and having less side–effects