Chitta Pratiksha1 , Mrunalini Alugolu2
BACKGROUND This study was conducted to compare the effect of intrathecal hyperbaric bupivacaine with clonidine 30 µg, fentanyl 25 µg and dexmedetomidine 5 µg in lower abdominal surgeries. METHODS 120 patients belonging to ASA 1 & II, aged between 20 and 50 years, posted for elective lower abdominal surgeries were randomly allocated into three groups with 40 subjects in each group. All patients received intrathecal hyperbaric bupivacaine 0.5%. Subjects in Group-C received clonidine 30 µg; subjects in Group-D received dexmedetomidine 5 µg, and subjects in Group-F received fentanyl 25 µg. RESULTS The patients studied across the groups did not vary much with respect to age, sex or height. The onset of motor blockade was earlier in dexmedetomidine group when compared to clonidine and fentanyl group. Duration of sensory blockade was prolonged in dexmedetomidine group when compared to clonidine and fentanyl group. Time duration of motor blockade was prolonged in dexmedetomidine group when compared to clonidine and fentanyl group. The difference of fall in systolic blood pressure, mean arterial pressure, and pulse rate between the groups at different time intervals studied was statistically insignificant and responded to treatment and hence these changes are clinically insignificant. The time of first request of analgesics by the patients was more in dexmedetomidine group when compared to clonidine and fentanyl group. Thus, prolonged duration of analgesia was observed in the dexmedetomidine group. The adverse effects observed in the study were minimal. CONCLUSIONS Use of intrathecal dexmedetomidine as an adjuvant to bupivacaine seems it to be a desirable alternative to fentanyl and clonidine for prolonged duration surgical procedures due to its profound intrathecal anaesthetic and analgesic properties combined with minimal side effects.
