Title: Intravenous Dexmedetomidine vs. Intravenous Clonidine to Prolong Bupivacaine Spinal Anaesthesia
Authors: Dr Sharvari P. Jagadale, Dr Vidya S.Kelkar
DOI: https://dx.doi.org/10.18535/jmscr/v7i8.53
Abstract
Aim: Intrathecal adjutants are being used to prolong the action of spinal anesthesia. Most of the studies have been conducted using intrathecal clonidine. This is a randomized clinical trial conducted to compare the effects of intravenous clonidine and dexmedetomidine on 0.5% bupivacaine in prolonging action of spinal anaesthesia.
Method: A prospective study of 120 patients undergoing lower limb and intra abdominal surgeries were divided into 3 groups: Group A — Received 0.9% saline infusion 20 minutes after spinal block. All patients received intravenous fluids as needed till the end of surgery. Group B — Received injection clonidine 2mcg/kg given as 20 minutes infusion started 20 minutes after spinal block and followed by a 0.9% saline drip till the end of surgery. Group C — Received an infusion of injection 1mcg/kg dexmedetomidine started 20 minutes after the spinal block and infused in 20 minutes, followed by 0.5mcg/kg/h dexmedetomidine drip till the end of surgery. Study was analyzed by Anova test. P value <0.05 was considered statistically significant.
Results: Patient demographics were comparable in all groups. Duration of sensory blockade was longer with group C (in minutes) (325.74± 10.59) than group B (270.41±11.98) and group A (222.54±15.03), p value 0.001. Duration of motor blockade was longer with group C (270.97± 6.15) than group B (243.67±9.22) & group A (208±12.83), p value (0.001). Duration of analgesia was longer with group C (366.13± 0.19) than group B (300±12.65) and group A (252.51±8.80), p value (0.001). Dexmedetomidine has more incidence of bradycardia and hypotension than other two groups but without any major clinical impact.
Conclusion: Intravenous dexmedetomidine and clonidine both prolongs action of spinal anaesthesia and postoperative analgesia than 0.5% hyperbaric bupivacaine. Dexmedetomidine has longer duration of action than Clonidine due to its alpha 2 receptor selectivity.
Keywords: Clonidine, Dexmedetomidine, Analgesia.
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