Abstract

Background and objectives: Various intrathecal adjuvants have been clinically tried for the prolongation of intraoperative and postoperative analgesia. This study aims at evaluating the effects of intrathecal nalbuphine and clonidine as adjuvants to isobaric levobupivacaine in subarachnoid block.
Methods: 60 patients scheduled for elective infra umbilical surgeries were allocated into two groups of thirty each to receive 15 mg of 0.5% isobaric Levobupivacaine with either 1mg nalbuphine (Group LN) or 30µg clonidine (Group LC) intrathecally. Characteristics of spinal anaesthesia in terms of sensory analgesia and motor blockade were noted. Haemodynamic parameters and adverse effects if any were recorded. Data obtained was compiled and statistically analysed with appropriate tests.
Results: Onset of sensory and motor block were faster in group LN (2.43 ± 0.93 and 2.2 ± 0.9 mins) compared to group LC (3.26 ± 1.04 and 3.13 ± 1.0 mins). However, time for two segment regression (186.8 ± 24.5 vs 146.5 ± 21.4), total duration of effective analgesia (384.1 ± 56.6 vs 292.1 ± 40.9) and total duration of motor block (345.3 ± 41.7 vs 235.6 ± 29.5 mins) were significantly prolonged in group LC than in group LN. There was no significant difference in haemodynamic changes and adverse effects between the groups.
Conclusion: The addition of 30µg clonidine intrathecally to 0.5% isobaric levobupivacaine is associated with prolonged sensory and motor blockade with better perioperative analgesia compared to 1mg nalbuphine.

Key words: Infra umbilical surgeries; Intrathecal; Nalbuphine; Clonidine; Isobaric Levobupivacaine.