Evaluation of analgesic effects of intrathecal clonidine along with bupivacaine in cesarean section

ABSTRACT

The objective of the present study was to evaluate the analgesic and adverse effects of intrathecal clonidine with hyperbaric bupivacaine in spinal anesthesia. Randomized single blind trial. 210 ASA l-ll pregnant females undergoing emergency cesarean section were randomized in a single-blind fashion to one of the three groups. In group I [n = 70] patients received 12.5 mg of 0.5% hyperbaric bupivacaine intrathecally. In group ll [n = 70] patients received intrathecal mixture of 0.5% hyperbaric bupivacaine [8 mg] and clonidine 50 /microg. In group III [n = 70] patients received 0.5% hyperbaric bupivacaine [10 mg] intrathecally along with 50/microg of clonidine. Groups were compared using one-way ANOVA with the Bonferroni multiple comparison post hoc test. The proportion of adverse events was compared using the chi-square test [lambda[2] = 57.2410]. On adding 50 micro g clonidine, we were able to reduce intrathecal dose of bupivacaine for cesarean section to 8 mg. Patients receiving intrathecal clonidine along with bupivacaine had significantly long lasting analgesia with lower bupivacaine dose [246.21 +/- 5.15 min. [group II] vs 146.0 +/- 4.55 min [group I], P=0.021; 95% confidence interval 238.01-257.40, group II and 134.99-157.0 group I. Addition of intrathecal clonidine causes some sedation in the postoperative period, but it provides adequate analgesia and motor paralysis at lower dose of bupivacaine. It also significantly prolongs postoperative pain relief