Abstract
Background and Aim: 2-Chloroprocaine (C13H19ClN2O2) an ultra-short acting, ester derivative of benzoic acid, is being investigated intrathecally in small doses (30 to 60 mg) and it was find reliable for procedures of short duration. Clonidine (C9H9Cl2N3) an imidazoline derivative, centrally-acting alpha2-adrenergic agonist, improves the quality of spinal bupivacaine and ropivacaine. It has not been studied in combination with 2-CP. So we conducted this study to evaluate effect of adding clonidine to spinal Chloroprocaine.
Methods: In this prospective randomized controlled study, spinal 2-CP (30 mg) with and without clonidine (30 mcg) in 60 adult patients posted for elective surgery of lower abdomen or lower limb. Patients were randomly divided randomly in 2 groups who received intrathecally either chloroprocaine (30mg+0.2 ml saline) or chloroprocaine (30 mg) with clonidine (30 mcg, 0.2ml). Hemodynamic changes, onset and duration of sensory blockade, onset and duration of motor blockade, 2-segment regression time,
Peak height for sensory block, time to attain peak height for sensory block were studied in both the groups.
Results: Mean systolic and diastolic blood pressures were significantly more decreased in group of patients who received clonidine with intrathecal chloroprocaine. Duration of sensory block averaged 3.90 ± 1.12 sec and 5.10 ± 1.55 sec without clonidine, time of peak heights of sensory block averaged 7.70 ± 1.56 sec with clonidine and 5.84 ± 1.61 sec without clonidine, duration of sensory blockade averaged 101.00 ± 14.99 min with clonidine and 54.77 ± 7.91 min without clonidine, mean 2-segment regression time was 76.63 ± 15.69 min with clonidine and 40.90 ± 6.99 min without clonidine, onset of motor blockade was averaged 4.40 ± 1.28 sec with clonidine and 6.5 ± 1.20 sec without clonidine, mean duration of motor blockade was 91.80 ± 14.47 min with clonidine and 48.30 ± 8.97 min without clonidine.
Conclusion: We found significantly enhancement in duration of motor and sensory blockade, peak height of sensory anaesthesia and 2 segment regression time by adding clonidine to intrathecal chloroprocaine. No significant adverse effects were seen in the patients while conducting the study. We found Chloroprocaine to be an effective and safe alternative for lower limb and lower abdominal surgeries of short duration.
Keywords: Chloroprocaine, Clonidine, Spinal Anaesthesia, Motor blockade, Sensory blockade.
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Corresponding Author
Dr Akash Gupta
Assistant Professor, Department of Anaesthesia, RMCH, Bareilly
DOI: https://dx.doi.org/10.18535/jmscr/v8i11.100
