Kiran Madhala1 , Poornima B.V.2 , Muthavarapu P.K. Teja3 , Sujay Kumar Parasa4
BACKGROUND Spinal anaesthesia with hyperbaric bupivacaine and adjuvants such as clonidine is now the preferred technique for spinal anaesthesia. In this study, we aimed to compare the block characteristics, intraoperative haemodynamics and postoperative pain relief in Caesarean section under subarachnoid block (SAB), following administration of hyperbaric bupivacaine and clonidine as a mixture in a single syringe and sequentially in two syringes. METHODS The research population consisted of 128 term parturient women undergoing elective caesarean section under spinal anaesthesia in the age group of 20 - 30 years. By using computer generated random numbers, they were allocated to one of the two classes of evenly sized groups (64 each). This is a forward-looking, comparative analysis using an inclusive protocol framework for similarly sized classes. Group A received intrathecal 2 mL of 0.5% hyperbaric Bupivacaine (10 mg) + 0.2 mL of clonidine (30 μg) as a mixture from the same syringe and Group B received intrathecal 2 mL of 0.5% hyperbaric Bupivacaine (10 mg) + 0.2 mL of clonidine (30 μg) (bupivacaine followed clonidine) sequentially from two syringes. RESULTS At baseline and in all subsequent measurements (p>0.05), the mean of arterial pressure, respiratory rate, and partial oxygen concentration were similar between the two groups. None of the cases in any group experienced nausea, vomiting and respiratory depression. CONCLUSIONS Sequential clonidine administration reduces the time needed for maximum sensory and motor block accomplishment and substantially prolongs the overall analgesic duration. We found that sequential procedure did not raise the degree of sedation and occurrence of hypotension or bradycardia as compared with drug administration as a mixture.
