Effect of Low Dose Intrathecal Clonidine As An Adjuvant to Hyperbaric Bupivacaine on Postoperative Analgesia In Patients Undergoing Elective Vaginal Hysterectomy Surgeries

Indian Journal of Applied Basic Medical Sciences
Year: 2019, Volume: 21(B), Issue. (2)
First page: (39) Last page: (48)
Online ISSN: 2249-7935
Print ISSN: 0975-8917
doi:

Effect of Low Dose Intrathecal Clonidine as An Adjuvant To  Hyperbaric Bupivacaine On Postoperative Analgesia In Patients  Undergoing Elective Vaginal Hysterectomy Surgeries 
Upasna Bhatia1, Ekta Soni2* , Ankita Patel3 , Ishita Thaker4
Associate Professor1 , Assistant Professor2 , II  yr Resident3, I yr Resident4 ,Department of anesthesiology ,AMCMET medical  college and LG hospital Maninagar ,Ahmedabad 
Corresponding author email id: ektabhanot@gmail.com

Online Published on 02-Jul-2019

ABSTRACT

Background  Spinal anaesthesia is preferred method for surgeries of lower half of the body due to its efficacy,  rapidity and minimal side effects. Generally bupivacaine is given as an spinal anaesthetic agent  because of its analgesic effect in the initial postoperative period. For additional post operative  analgesia effect it is recommended to add an adjuvant . Hence the present study was aimed to  compare the effects of combination of clonidine as an adjuvant to bupivacaine and bupivacaine  alone.  Method  The study was prospective, randomized, double blinded and controlled study. 60 indoor patients  between age group of 25-70 years of ASA physical status I/II posted for elective vaginal  hysterectomy were selected for the study. Parameters like post operative analgesia, onset, peak level  and two segment regression of sensory block and onset, peak and recovery of motor block, time of  rescue analgesia and various side effects were assessed on administration of clonidine at a dose 30µg  intrathecally with 3ml of 0.5% bupivacaine and comparing the same with bupivacaine hydrochloride  alone with 0.2ml of normal saline.  Results:   Demographic profile Of the patientswere similar in both the groups . The time of onset of peak  sensory block was significantly faster (87±15.9 seconds, p<0.0001) in clonidine group as compared  to control (168 ± 13seconds) . Similarly, time of onset of Grade III motor block (just able to move  knees) was significantly quicker (177±19.64seconds, p<0.01) in clonidine group as compared to  saline (348±21 seconds). The mean time from injection to regression of level of sensory analgesia up  to L1 ( duration of sensory block ) was 285±14 min in clonidine group which was significantly  longer than the duration of 140.6±12.5 min in control group (p<0.01). Duration of analgesia in the  group C (488 ± 20minutes) was significantly more in comparison to 180 ± 25 minutes in control  group (p<0.0001).  Conclusions  It is concluded that patients receiving 30µg intrathecally with 3ml of 0.5% bupivacaine dose  produces significant anaesthetic, analgesic effect and lesser side effects compared to bupavacaine  alone receiving group.

Keywords

Spinal anaesthesia, Intrathecal clonidine, Bupivacaine 

[pms-restrict subscription_plans=”10827″]

[/pms-restrict]