Introduction: Epidural anaesthesia/analgesia with adjuvant is the preferred method for intra and postoperative pain relief in lower abdominal and lower limb surgeries but search for ideal adjuvant without any side effect goes on. Alpha (2 ) adrenergic agonists have both analgesic and sedative properties when used as an adjuvant in regional anesthesia. Aim: It is a comparative study of post operative analgesia with epidural Clonidine and epidural normal saline in patients undergoing lower abdominal and lower limb surgeries using combined spinal epidural technique. Materials and Methods: The present study was undertaken during the period of May 2015 to October 2016. 100 patients posted for elective major lower abdominal and lower limb surgeries were selected and allocated randomly into two groups. Each group has 50 patients. Group 1:­Patients received intrathecal 0.5% Hyperbaric Bupivacaine + epidural Clonidine 1µg/kg or 50µg whichever is lower, diluted to 10ml with normal saline. Group 2:­ Patients received intrathecal 0.5% Hyperbaric Bupivacaine + epidural 10ml normal saline. Quality of analgesia, duration of analgesia and duration of motor blockade between the two groups were compared. Patient vitals like pulse rate, blood pressure, respiratory rate, SPO2 and ECG were monitored during the study. During the study patients were observed for the side effects like nausea, vomiting, hypotension, bradycardia and dryness of mouth. Results: In present study majority of patients were in the age group between 31­50 yrs in both the groups and most of them weigh between 61­70 kgs. Total abdominal hysterectomy cases were majority cases observed in both groups. Quality of analgesia is excellent in both the groups and none of the patients complained of severe pain. Mild pain was observed in most of the cases in both the groups. The average time taken for 2 segment regression is more in Clonidine group compared to control group. The total duration of analgesia is more in Clonidine group compared to control group. The time taken for 1st movement i.e. beginning of motor recovery is more in Clonidine group compared to control group. Mean pulse rate, systolic BP and diastolic BP changes are statistically significant in Group 1. Complications observed in Group 1 were nausea & vomiting in 7 patients, hypotension in 7 patients, bradycardia in 1 patient, sedation in 1 patient, dry mouth in 2 patients. Hypoxia and bleeding were not reported. Conclusion: Quality of analgesia is excellent in patients receiving Clonidine when compared to placebo group. Total duration of analgesia and motor blockade is significantly prolonged in Clonidine group compared to placebo group. Minimal side effects like mild hypotension, mild sedation and dryness of mouth were seen in Clonidine group which does not require any active intervention.

Keywords: Epidural Analgesia; Bupivacaine; Clonidine.