Title: Effects of Addition of Clonidine to Bupivacaine in Spinal Anaesthesia for Abdominal Hysterectomy
Authors: Rehana B, Divya Madhu
DOI: https://dx.doi.org/10.18535/jmscr/v5i6.22
Abstract
Hyperbaric bupivacaine is a commonly used local anaesthetic for subarachnoid blocks. Several additives are added to prolong the action of intrathecal bupivacaine. We evaluated the effects of addition of 60μgms clonidine to 0.5% hyperbaric bupivacaine on the quality of subarachnoid block and vital parameter changes. Hundred ASA l and ll patients aged between 30 and 60 years for elective abdominal hysterectomy were randomly allocated into two equal groups, Group B receiving 0.5% hyperbaric bupivacaine 3ml with 0.4ml Saline and Group B+C receiving 60μgms clonidine (0.4ml) with 3ml of 0.5% hyperbaric bupivacaine).Time of onset of sensory block ,Level of block ,Time to regression of sensory block to T10 level , Duration of motor block ,Duration of pain relief, Changes in blood pressure, heart rate and side effect profile of intrathecal clonidine were studied. The onset of sensory block to T6 and the highest sensory level were similar in both groups. Time to regression of sensory block to T10 (256.04+20.61vs 146.08+9.91 minutes, p<0.001) and duration of motor block (189.02+16.93 vs 141.66+10.78 minutes, p<0.001) were significantly prolonged in the clonidine group. Effective analgesic time was also significantly longer in patients given clonidine (330.16+25.07 vs 163.26+21.11 minutes, p<0.001). Clonidine group showed a significant decrease in systolic blood pressure, but incidence of bradycardia was unchanged. Addition of 60μgms of clonidine enhances the anaesthetic properties of intrathecal bupivacaine, prolongs the duration of sensory and motor block and improves early postoperative pain relief with minimum side effects and serves as a useful adjuvant in spinal anaesthesia.
Keywords: Clonidine, Bupivacaine, Spinal anaesthesia, Abdominal hysterectomy.
