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Evaluation and comparison of intravenous clonidine and intravenous dexmedetomidine on duration of bupivacaine spinal anesthesia

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Original Article

Author Details : Kalyani Nilesh Patil, Kavita Udaykumar Adate, Shalini Pravin Saredesai

Volume : 4, Issue : 1, Year : 2017

Article Page : 64-68

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Abstract

Context: Alpha-2 agonists improve the block characteristics in regional anesthesia, when added to local anesthetics.
Aim: To evaluate and compare efficacy of dexmedetomidine and clonidine, as an intravenous adjuvant to intrathecal bupivacaine.
Settings and Design: Prospective, randomized, double-blind placebo-controlled study.
Methods and Material: 75 patients of American Society of Anaesthesiologists status I or II, scheduled for orthopaedic lower limb surgery under spinal anaesthesia, were randomly allocated into three groups of 25 each. Patients in group D received dexmedetomidine 1?g/kg; group C received clonidine 2?g/kg and group PL received physiological saline, each premixed to 20 ml intravenously over 20 min, starting 20 min after the subarachnoid block with 15 mg of 0.5% hyperbaric bupivacaine. Duration of sensory and motor blockade, postoperative analgesia, sedation scores and side effects were recorded.
Statistical analysis used: Parametric testing done using one-way analysis of variance (ANOVA), intergroup comparison with post-hoc analysis Tukey’s test. Categorical data analyzed using Chi-square test. P< 0.05 was statistically significant.
Results: Duration of sensory block was significantly prolonged by dexmedetomidine (231.20+24.84 min) and clonidine (200+23.67 min) than placebo (171+12.25 min) (p<0.001). Duration of motor block was 135.20+12.87 min with placebo, 180.40+24.70 min with clonidine and 205.20+25.56 min with dexmedetomidine (p<0.001). Postoperative analgesia was significantly prolonged by dexmedetomidine (255+23.14 min) than by clonidine (221.40+ 24.30 min) and placebo (202.60+14.08 min) (p<0.001). The mean sedation score was significantly higher in dexmedetomidine group.
Conclusion: Single-dose intravenous dexmedetomidine and clonidine given after spinal anaesthesia prolong duration of sensory and motor block and postoperative analgesia.

Keywords: Clonidine, Dexmedetomidine, Spinal anesthesia.
Key Messages: Alpha-2 agonists prove to be useful intravenous adjuncts to spinal anesthesia. They effectively prolong the duration or both sensory and motor block as well as postoperative analgesia, without any clinically significant adverse effects

 

How to cite : Patil K N, Adate K U, Saredesai S P, Evaluation and comparison of intravenous clonidine and intravenous dexmedetomidine on duration of bupivacaine spinal anesthesia. Indian J Clin Anaesth 2017;4(1):64-68

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