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A comparison of effects of intrathecal clonidine and intravenous clonidine on duration of spinal anaesthesia

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Original Article

Author Details : Namrata Ranganath, Arathi BH

Volume : 3, Issue : 4, Year : 2016

Article Page : 556-561

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Abstract

Introduction: There are studies which infer that spinal anaesthesia can be prolonged after adding adjuvants to local anaesthetics or by oral premedication before the block is performed.
Aim of our study: To prolong the duration of spinal anaesthesia after the block has been performed. 
The study was done to compare the effects of intrathecal and intravenous clonidine on duration of spinal anaesthesia and to evaluate any advantages or disadvantages of intravenous over intrathecal clonidine in terms of analgesia, sedation, post–operative shivering and hemodynamic stability.
Methodology: A prospective randomized double blind controlled comparative clinical study,   was conducted on 60 patients, aged 20-60 years belonging to ASA I and II scheduled for elective infraumbilical procedures. Patient were divided into three groups of 20 each randomly, Group A- intrathecal bupivacaine (0.5% heavy) 3ml (15mg) + 75mcg of intrathecal clonidine, Group B- intrathecal bupivacaine (0.5% heavy) 3ml (15mg) + 3 mcg/Kg of intravenous clonidine over 10min, Group C – (control group) - intrathecal bupivacaine (0.5% heavy) 3ml (15mg) + 0.5ml of normal saline, intrathecally in L3-L4 interspace with a 25G Quinke’s needle. Intraoperatively the parameters noted were; Sensory characteristics- Time of onset of analgesia (T10), Maximum level of analgesia achieved, Time taken for maximum level of analgesia, Time for sensory block to regress to T10, Total duration of analgesia(rescue analgesic on patient demand). Motor characteristics- Time of onset of motor blockade (grade 1 bromage), Maximum grade of motor blockage achieved, Total duration of motor blockade (regression to Bromage-I), Hemodynamic monitoring, Sedation levels (OAA/Sscale) and Shivering episodes.
Statistical software: The Statistical software namely SAS 9.2, SPSS 15.0, Stata 10.1, MedCalc 9.0.1, Systat 12.0 and R environment ver.2.11.1 were used for the analysis of the data and Microsoft word and Excel have been used to generate graphs, tables.
Results: Intravenous clonidine after bupivacaine spinal anaesthesia has characterstics similar to and comparable with intrathecal clonidine with bupivacaine with an added advantage of significant. Intraoperative and post-operative sedation, Protection against postoperative shivering and Beneficial in prolonged surgeries.

Keywords: Clonidine, Spinal anaesthesia, Bupivacaine, Motor blockade, Analgesia

How to cite : Ranganath N, Arathi Bh, A comparison of effects of intrathecal clonidine and intravenous clonidine on duration of spinal anaesthesia. Indian J Clin Anaesth 2016;3(4):556-561

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