A Comparative Study of Clonidine and Dexmedetomidine as Adjuvant in Neuraxial Block – A Case Series

Abstract

BACKGROUND-Most of the lower abdominal surgeries are performed under spinal anaesthesia which is a popular technique using hyperbaric local anaesthetic solutions such as 0.5% Bupivacaine. The advantages are simplicity of technique, rapid onset of action and reliability in producing uniform sensory and motor blockade. Main disadvantage of using plain local anaesthetic agent arelimited duration of action and lack of longer postoperative analgesia.To overcome this problem, administration of different adjuvant in local anaesthetic is an excellent technique. AIMS-To compare the effect of adding Clonidine and Dexmedetomidine to Bupivacaine for neuraxial block. METHODS-This study was be conducted after the approval of institutional ethical committee. It is a prospective study in which 75 selected patients who were posted for lower abdominal surgeries were randomly allotted into three groups.Group B -Inj.0.5% Heavy Bupivacaine 3.2cc(16 mg) + Inj. Normal saline Group C -Inj.0.5% Heavy Bupivacaine 3.2cc(16 mg) + Inj.Clonidine 30 mcgGroup D -Inj.0.5% Heavy Bupivacaine 3.2cc(16 mg) + Inj.Dexmedetomidine 3 mcg, Total volume injected in all group was 3.5 ml.The end of drug injection was taken as zero time. Onset, duration of sensory blockade, duration of motor blockade was noted. RESULTS –prolonged sensory and motor blockage and superior post-operative analgesia was observed in group D. CONCLUSION- Addition of Dexmeditomidine 3 mcg is significantly more effective than plain 0.5% Bupivacaine or when Clonidine 30mcg was used as adjuvant, for prolongation of sensory and motor blockage and post-operative analgesia.