Comparison of efficacy of Intrathecal Fentanyl, Clonidine and Fentanyl- Clonidine combination as adjuvant to Bupivacaine for lower limb orthopaedic surgeries

BHARATHI S; SHANKARANARAYANA P

Volume : IX, Issue : II, February - 2020

Comparison of efficacy of Intrathecal Fentanyl, Clonidine and Fentanyl- Clonidine combination as adjuvant to Bupivacaine for lower limb orthopaedic surgeries

Bharathi S, Shankaranarayana P

Abstract :

INTRODUCTION The aim of my study was to assess block duration, analgesic consumption, time from block insertion until first administration of analgesic, visual analogue scores for assessment of pain, and block–related and analgesic related complications. MATERIALS AND METHODOLOGY This is a prospective randomized doubled blinded study consisting of 90 patients of ASA physical status I–III of both sexes, aged between 18 and 70 years and weighing 40–70kgs, scheduled for lower limb orthopaedic surgeries under sub–arachnoid block. Patients were randomly divided into 3 groups of 30 patients each as:– • Group BC – Inj 0.5% Bupivacaine heavy 2.5ml+ Inj Clonidine 30mcg. • Group BF – Inj 0.5% Bupivacaine heavy 2.5ml + Inj Fentanyl 25mcg. • Group BCF – Inj 0.5% Bupivacaine heavy 2.5ml + Inj Fentanyl 12.5mcg + Inj Clonidine 15mcg. Onset and duration of sensory and motor blockade, haemodynamic parameters, total duration of post–operative analgesia for 24hrs using VAS score, time of first analgesic requirement and side effects were recorded. RESULTS In our study we found that the duration of motor blockade was superior in Group BCF compared to Group BC and Group BF with stable haemodynamic parameters and the requirement of post–operative analgesia in the first 24hrs significantly lower with group BCF when compared to group BC and group BF. CONCLUSION Ultralow doses of Fentanyl and Clonidine when added as adjuvants to intra–thecal 0.5% Bupivacaine was superior to either drug added alone in prolonging the duration of sensory and motor blockade and maintaining better haemodynamic stability and reduced side effects.