Comparison of Haemodynamic and Analgesic Effects of 0.5% Hyperbaric Bupivacaine and 0.5% Hyperbaric Bupivacaine with Different Doses of Clonidine under Spinal Anaesthesia
Journal Title: International Journal of Medical Research Professionals - Year 2017, Vol 3, Issue 2
Abstract
Background: Alpha 2 agonists such as clonidine have been used neuroaxially as local anaesthetic adjuvant to enhance perioperative analgesia. This study compared three different combinations of the clonidine with bupivacaine and bupivacaine alone. Material and Methods: A total of 60 patients scheduled for surgery under spinal anaesthesia were randomly allocated into 4 groups (n=15 each) to receive intrathecal bupivacaine 15 mg [Control group (group 1)], bupivacaine 15 mg + clonidine 0.5 mcg/kg (group II), bupivacaine 15 mg + .75 mcg/kg clonidine (group III), bupivacaine 15 mg + 1mcg/kg clonidine (group IV). Heart rate, SBP, DBP, MAP, oxygen saturation were monitored. The level of the sensory block recorded every 5th min till 20th min with level achieved at 20th min was considered as highest dermatome level achieved, time to onset of different grades of motor block, time to complete motor block, recovery and duration of spinal analgesia were recorded. p value <0.05 considered significant. Results: Demographic data and duration of surgery were comparable amongst the groups. On haemodynamical comparison there was highly significant fall in heart rate, systolic and diastolic in group II,III,IV as compared to I. There was no incidence of bradycardia in group I whereas there were 2, 4 and 11 cases in group II,III,IV respectively. Similarly there was no hypotension in group I whereas there were 2, 5 and 11 cases in group II,III,IV respectively. On statistical analysis the level of sensory block was comparable at 5 min and highly significant at 10, 15, 20 mins in group II,III,IV as compared to I. The attainment of the different grades of motor block (modified bromage scale) at 5, 10, 15, 20 min interval was comparable amongst all groups. The duration of analgesia was highly significant when analysed statistically (p=0.000) in group II,III,IV as compared to I. Conclusion: In conclusion our study demonstrates that addition of 0.75 μg/Kg of clonidine to intrathecal bupivacaine is safe as compared to 1.0 μg/Kg. By using small dose of intrathecal clonidine side effects were not increased whereas intrathecal clonidine at the usual dose of 1μg/kg is associated with bradycardia and relative hypotension. So, 0.75 μg/Kg of clonidine is the preferred dose for addition to 0.5% hyperbaric bupivacaine in patients undergoing gynaecological and lower abdominal surgeries.
Authors and Affiliations
Balwinder Kaur Rekhi, Harnam Singh Rekhi, Sahil Satish Arora, Sandeep Sidhu, Amita Mhatre Arora
Keywords
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- EP ID EP543841
- DOI 10.21276/ijmrp.2017.3.2.027
- Views 68
- Downloads 0
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