Effect Of Low Dose Intrathecal Clonidine As An Adjuvant To Hyperbaric Bupivacaine On Postoperative Analgesia In Patients Undergoing Elective Vaginal Hysterectomy Surgeries

ABSTRACT

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 gr