Comparative study of intrathecal bupivacaine and clonidine combination versus bupivacaine and dexmedetomedine for gynaecological procedures
Journal Title: Medpulse International Journal of Anesthesiology - Year 2017, Vol 2, Issue 1
Abstract
Background: Gynaecological procedures are often done under regional anaesthesia.Various adjuvants are being used with local anesthetics for prolongation of intraoperative and post-operative analgesia. Dexmedetomidine, a highly selective alpha-2adrenergic agonist, has emerged as a valuable adjunct to regional anesthesia and analgesia.The study was aimed to compare the onset, duration of sensory and motor block, hemodynamic effects, post-operative analgesia, and adverse effects of dexmedetomidine and clonidine with bupivacaine for spinal anesthesia. Material and Methods: A total of 50 patients belonging to ASA Grade 1 and 2 undergoing elective gynecological surgery under spinal anesthesia were studied. The patients were allocated in two groups (25 each). Group I bupivacaine + clonidine (B+C) received 17.5 mg of bupivacaine supplemented 45 mcg clonidine and Group II bupivacaine + dexmedetomidine (B+D) received 17.5 mg bupivacaine supplemented 5 mcg dexmedetomidine. The onset time of sensory and motor level, time to reach peak sensory and motor level, hemodynamic changes and side effects were recorded. Results: Mean time of onset of sensory block in Group I and Group II were found to be 3.65±0.68 mins and 2.78±0.20 mins respectively (p>0.05). The onset of motor block in Group I was slightly less than Group II. Five patients in Group I B+C and nine patients from group II B+D had significant bradycardia and hypotension. Nausea and vomiting was reported in one case in group I B+C shivering was reported in 1 case of each group. Discussion: Use of intrathecal dexmedetomidine as an adjuvant to bupivacaine seems to be an attractive alternative to clonidine for long duration gynecological surgical proceduresdue to its profound intrathecal anesthetic and analgesic properties combined with minimal side effects.
Authors and Affiliations
Madhuri Pramod Lonikar, Shubhada Anand Patil, Mohd. Imran Haroon
Keywords
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