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A prospective randomized study comparing the efficacy of intrathecal clonidine versus dexmedetomidine as adjuvants to hyperbaric bupivacaine in patients undergoing spinal anesthesia for pelvic and lower limb orthopedic surgeries

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Original Article

Author Details : Dushyant Chavda, Shreya Patel*, Nilesh Shah, Payal Berawala, Sara Mary Thomas

Volume : 12, Issue : 1, Year : 2025

Article Page : 73-79

https://doi.org/10.18231/j.ijca.2025.011

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Abstract

Background: Low-dose bupivacaine used in spinal anaesthesia results in speedy recovery. Adjuvants could be added to provide sufficient anaesthesia for surgery. Dexmedetomidine and clonidine are selective ?-2 adrenoceptor agonists and are used as adjuvants in different doses to prolong the duration.
Aim is to determine time of onset of motor and sensory block, time to achieve highest level in sensory block, duration of motor block and sensory block and need for first rescue analgesia and any side effects.
Materials and Methods: Fifty patients scheduled for lower limb and pelvic orthopedic surgeries under spinal anesthesia were divided into two groups. The dexmedetomidine group (D10, n=25) received 3.4 ml of 0.5% heavy bupivacaine combined with 10 µg of dexmedetomidine, totaling 3.5 ml. The clonidine group (C15, n=25) received 3.4 ml of 0.5% heavy bupivacaine with 15 µg of clonidine, also totaling 3.5 ml, administered intrathecally.
Result: The onset of sensory and motor block was significantly earlier, and the duration of both motor and sensory block was longer in the dexmedetomidine group compared to the clonidine group (p-value < 0> Conclusion: Intrathecal administration of bupivacaine with 10 µg of dexmedetomidine results in an earlier onset and longer duration of both sensory and motor block compared to 15 µg of clonidine. This combination also provides increased analgesia time and delays the need for the first rescue analgesia. Dexmedetomidine proves to be a superior adjuvant to clonidine, enhancing patient satisfaction and offering better quality of analgesia.
 

Keywords: Bupivacaine, Clonidine, Dexmedetomidine, Intrathecal analgesia, Orthopedic surgery, Spinal anesthesia.

How to cite : Chavda D, Patel S, Shah N, Berawala P, Thomas S M, A prospective randomized study comparing the efficacy of intrathecal clonidine versus dexmedetomidine as adjuvants to hyperbaric bupivacaine in patients undergoing spinal anesthesia for pelvic and lower limb orthopedic surgeries. Indian J Clin Anaesth 2025;12(1):73-79

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