L.R.N.N. Paidikondala1, Kommula Gopala Krishna2, Harika Surabattula3, N. Nagalakshmi4
BACKGROUND
Clonidine and dexmedetomidine are two α-2 adrenergic receptor agonists which
have been used as an adjuvant to intrathecal local anaesthetics. Both drugs act
by different mechanisms and potentiate the effect of each other. The purpose of
the study was to assess the efficacy and safety of adding clonidine and
dexmedetomidine to intrathecal hyperbaric bupivacaine on spinal block
characteristics in gynaecological procedures.
METHODS
This study was conducted as a prospective comparative, randomized, double blind,
placebo-controlled trial. Based on exclusion and inclusion criteria, 90 patients were
included in this study by using a computer generated randomization. Patients were
randomly divided into three groups each as follows: Gr BD: 0.5 % hyperbaric
bupivacaine (3.5 ml) + 3 μg preservative free dexmedetomidine (total volume of
4 ml), group BC: 0.5 % hyperbaric bupivacaine (3.5 ml) + 0.5 ml clonidine (30
μg) (total volume of 4 ml), group BN (control): 3.5 ml of 0.5 % hyperbaric
bupivacaine + same volume normal saline. The spinal block characteristics,
hemodynamic stability, and side effects were compared.
RESULTS
Time to reach sensory block to T10 was 2.52 ± 0.33 minutes in group BN, 1.95 ±
0.38 ms in gr BC and 1.53 ± 0.24 minutes in group BD. The span of sensory block
was longer in group BD in comparison to group BC (453.76 ± 52.78 v 389.36 ±
37.4) and group BN (453.76 ± 52.78 vs. 173.33 ± 14.56). Time for rescue
analgesia was 169.12 ± 21.14 minutes in group BN, 245.21 ± 32.42 minutes in
group BC and 289 ± 24 minutes in group BD.
CONCLUSIONS
When α-2 adrenergic receptor agonist is used intrathecally with bupivacaine, early
motor and sensory block can be achieved along with long span of analgesia.
