Opioids and local anesthetics administered together intrathecally are known to have synergistic analgesic effects. [1] Fentanyl, a short-acting lipophilic opioid, was administered intrathecally along with local anesthetics by Belzarena. [2] Clonidine, an α 2 adrenergic agonist, has been used as an antihypertensive agent for many years. Recently its desirable anesthetic properties in human have been highlighted, which include reducing anesthetic requirements, improving hemodynamic stability, and providing analgesia. [3-5] The problem of postoperative pain relief seeks utmost attention since past few years. Postoperative pain treatment should be an integral component of the routine surgical and anesthetic management because it helps to reduce morbidity and complications as well as accelerate rehabilitation. [6] Good postoperative analgesia is an important avenue to attenuate the surgical stress response. [7] When local anesthetic bupivacaine is combined with intrathecal clonidine, complete surgical anesthesia could be obtained along with intra-and postoperative pain relief with fewer side effects. [5,8-10] Clonidine has been used as an Background: Various adjuvants have been used in spinal anesthesia to avoid intraoperative visceral and somatic pain and prolonged postoperative analgesia. Clonidine, partially selective α 2-agonist drug, is now being used as a neuraxial adjuvant. Objective: To compare the duration and quality of analgesia of clonidine and fentanyl used as adjuvants to intrathecal bupivacaine. Materials and Methods: American Society of Anesthesiologist grade 1 and 2 patients (90 patients) were randomly divided into three groups of 30 patients each for lower limb orthopedic surgeries. Group A received intrathecal 15 mg hyperbaric bupivacaine and 1 ml normal saline, group B received 15 mg hyperbaric bupivacaine and 1 ml (50 µg) fentanyl, and group C received 15 mg hyperbaric bupivacaine and 1 ml (150 µg) clonidine. The onset and duration of sensory and motor block, quality of analgesia, and the incidence of side effects in three groups were observed and compared. Results: Three groups were compared based on the demographic data, and the onset of sensory block at T 8 level and of motor block was compared among these groups. Significant prolongation of duration of sensory (P = 0.0000001) and motor block (P = 0.0000001) was found in group C. Significant hypotension was found in group C (P < 0.05) and the postoperative pain scoring chart (VAS chart) was 1.07 ± 0.87 in group C and 3.27 ± 0.67 in group B (P < 0.05). Conclusion: Intrathecal clonidine is associated with prolonged motor and sensory block, hemodynamic stability, and low postoperative pain score compared to fentanyl.

Background: Hysterectomies are the surgeries which are associated with visceral and somatic pain. To prolong sensory block and get good perioperative analgesia, various adjuvants are under trial. Aims & Objective: To study the effects of low dose of intrathecal Dexmedetomidine as adjuvant to Bupivacaine in hysterectomies. Materials and Methods: This was a prospective randomized double blind control study. Sixty patients were randomly allocated into two group to receive intrathecal either 3.5 ml of 0.5 % hyperbaric Bupivacaine + 0 .5 ml normal saline in Group I, or 3.5 ml of 0.5% hyperbaric Bupivacaine + 0.5ml of 5 µg Dexmedetomidine in Group II. Demographic data, haemodynamic, onset and duration of sensory and motor block and other side effects were analyzed. Statistical analysis was done by using f test and t test in data analysis add in package of the Microsoft Excel. Results: Two groups were comparable with respect to demographic data. Onset of sensory block at T10 level was comparable in both groups. However the onset of motor block was found early in Group II (P value 0.006). There was significant prolongation of duration of sensory and motor block found in group II. For sensory block (P value: 0.0018 × 10-8) and motor block (P value: 0.002 × 10-6). Haemodynamic, nausea, vomiting, shivering data findings were comparable. There was significant sedation found in Group II (P value: 0.0047 × 10 8). Conclusion: Low dose of intrathecal Dexmedetomidine prolonged the duration of sensory and motor block with the significant sedation level.

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