Vol. 4, Issue 1 (2019)
The effect of intrathecal clonidine versus intravenous clonidine on duration of spinal anaesthesia with 0.5% hyperbaric bupivacaine, a randomised controlled trial
Author(s): Dr. Oswald Jason Azavedo, Dr. Anish Sharma NG, Dr. Rameshbabu M
Abstract: Background: Spinal anaesthesia can be prolonged after adding adjuvants to local anaesthetics or by intravenous route before the block is performed. Aim of the work: To prolong the duration of spinal anaesthesia after the block has been performed. The study was done to compare the effects of intrathecal (IT) and intravenous (IV) clonidine on duration of spinal anaesthesia andtoevaluateany advantagesordisadvantagesofIVoverITclonidineintermsofanalgesia,sedationandhemodynamicstability. Patients and Methods: After ethical clearance, informed and written consent, patients undergoing elective abdominal and lower limb surgeries, were assessed for the inclusion and exclusion criteria. Patients were randomised into two groups of 50 each using computer generated numbers. Group A: This group of individuals was given intrathecal bupivacaine 15mg + clonidine 1 mcg/kg consisting of 50 patients. Group B: This group of individuals was given slow intravenous clonidine 1 mcg/kg 15 minutes before spinal anaesthesia + intrathecal bupivacaine 15mg consisting of 50 patients. Patients were assessed for pain by visual analogue scale (VAS), blood pressure (BP), Heart rate (HR), respiratory rate (RR), oxygen saturation pulse oxymetry (SPO2), sedation, nausea, vomiting at 0 minutes (min), 2 mins, 4 mins, 6 mins, 8 mins, 10 mins, 15mins, 30 mins, 45 mins, 1 hour (hr), 2 hour and 1 hourly until the surgery is over. Postoperatively assessed for pain VAS, BP, HR, SPO2, RSS 1 hourly till 24 hours. Results:Intravenous clonidine before bupivacaine spinal anaesthesia has characterstics similar to and comparable with intrathecal clonidine with bupivacaine in terms of sensory and motor onset; maximum sensory and motor block achieved; duration of motor block; duration of analgesia; hemodynamic stability, with an added advantage of significant intraoperative and postoperative sedation. Conclusion: Our study has demonstrated that addition of clonidine to intravenous and intrathecal spinal bupivacaine significantly increases the duration of analgesia and motor blockade.