Comparison of Intrathecal Bupivacaine, Ropivacaine (0.75%) and Ropivacaine (0.75%) with Clonidine (30µg) for Lower Abdominal and Lower Limb Surgeries with Regard to Quality of Anaesthesia and Safety

Abstract

Background: A prospective randomized study was conducted to study the efficacy and safety of Bupivacaine, Ropivacaine and Ropivacaine with clonidine intrathecally for lower abdominal and lower limb surgeries. Methods: 120 patients undergoing lower abdominal and lower limb surgeries of 120 minutes or lesser duration were randomized into three groups, n = 40. Group A received 3 ml 0.5% Bupivacaine (15 mg)+ 0.2ml normal saline, Group B received 3 ml of 0.75% isobaric Ropivacaine (22.5 mg)+ 0.2ml normal saline and Group C received 3ml of 0.75% Ropivacaine (22.5mg)+ clonidine 30 µg. Quality of subarachnoid blockade and hemodynamic changes were compared. Results: Onset time and time to maximum motor blockade was rapid in all the three groups ; duration of motor blockade was significantly shorter in Ropivacaine group and comparable between Bupivacaine and Ropivacaine with clonidine group. Onset of sensory blockade and maximum sensory block level achieved were comparable between three groups. Time to, onset of maximum sensory block and regression of sensory block by 2 segments were shorter in the Bupivacaine group compared to the other 2 groups. Better hemodynamic profiles were noted in Ropivacaine groups compared to Bupivacaine group. There were no statistically significant differences between the Quality of sedation and the side effects between the groups. Conclusion: Hemodynamic profile was better with Ropivacaine and onset, quality, duration of analgesia, etc. were comparable with Bupivacaine when clonidine 30µg was added as adjuvant.