Journal of Clinical Anaesthesiology: Open Access

Comparison of Intrathecal Clonidine in Bupivacaine, Bupivacaine only with Placebo in Patients Scheduled for Lower Limb Orthopaedic Surgery

Abstract

Harsimran Kaur, Aruna Jain, Manpreet Singh

Background and Objectives: Clonidine is a partially selective alpha-2 adrenergic agonist and has extensively been studied intrathecally in regional anaesthesia. With this background, the present study was conducted to compare the clinical efficacy of two different doses of intrathecal clonidine in hyperbaric bupivacaine with hyperbaric bupivacaine alone in terms of duration of post-operative analgesia, quality of surgical anaesthesia, incidence of hypotension and bradycardia in lower limb orthopedics surgeries.

Methods: Total of 150 patients was randomly allocated to 3 groups of 50 patients each. Group I received 2.5 ml of 0.5% hyperbaric bupivacaine+1 ml NS (Normal Saline); Group II received 2.5 ml of 0.5% hyperbaric bupivacaine+0.5 ml clonidine (75 mcg)+0.5 ml NS; group III received 2.5 ml of 0.5% hyperbaric bupivacaine+1 ml clonidine (150 mcg). Intraoperatively, onset of sensory and motor block, highest sensory level achieved, time to reach it, haemodynamic parameters and sedation scoring were noted. Postoperatively haemodynamics, duration of sensory/motor block, sedation and duration of effective analgesia were noted.

Results: Group II patients had effective postoperative analgesia with excellent quality of surgical anaesthesia, effective sedation score and showed significant hypotension. Group III patients had highest incidence of bradycardia.

Conclusion: This study concluded that 75 mcg clonidine is an effective adjuvant to 0.5% hyperbaric bupivacaine when used intrathecally in lower limb orthopaedic surgeries. Incidence of hypotension and bradycardia is lesser in 75 mcg than 150 mcg clonidine.