Abstract
Background: Clonidine, an imidazole derivative with α-2 adrenergic agonist action, when used intrathecally gives good analgesia and is claimed to have minimal side effects as compared to opioids1. We evaluated the effects of low dose intrathecal clonidine as an adjuvant to hyperbaric bupivacaine on postoperative analgesia in patients undergoing elective infraumbilical surgeries.
Methodology: In a prospective, double blind, randomized controlled study, 60 patients undergoing elective infraumblical surgeries were randomly divided into two groups of 30 each. Group 1 received 15mg of 0.5% hyperbaric bupivacaine with 0.5mcg/kg clonidine and Group 2 received 15mg of 0.5% hyperbaric bupivacaine with normal saline (same volume). The onset of sensory block, duration of motor blockade, VAS score and time for first rescue analgesia were noted. Patients were monitored for any side effects.
Results: Demographic profile of the patients were similar in both the groups. Group 1 had faster onset of sensory blockade (p< 0.001) as compared to Group 2. Mean time for 2 segment sensory level regression was delayed in Group 1. Group 1 noted a prolongation in duration of analgesia i.e., 165.43 +/-23.13 mins as compared to Group 2 where rescue analgesia was demanded earlier.
Conclusion: Intrathecal clonidine in a dose of 0.5mcg/kg shortens the onset of sensory blockade, increases the duration of sensory blockade and complete motor recovery. Duration of postoperative analgesia is significantly prolonged and the time for requirement of rescue analgesia is prolonged without causing significant side effects if clonidine is used in low doses.
Key words: intrathecal, clonidine, bupivacaine, infraumbilical surgeries
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