Background and Aims: Pain is the most common symptom seen postoperatively and multiple approaches are used to overcome it. In this study, we compared bupivacaine and bupivacaine – clonidine combination in transversus abdominis plane (TAP) block for postoperative analgesia in patients undergoing inguinal hernioplasty under spinal anaesthesia.

Methods: Sixty ASA I and II male patients in the age group of 18 to 60 years posted for inguinal hernioplasty were randomly divided into two groups (Group B and Group C). The procedure was done under spinal anaesthesia using 3 ml of 0.5% hyperbaric bupivacaine. After the surgery, ultrasound guided TAP block was given with 19.5 ml of 0.25% bupivacaine + 0.5 ml sterile water in Group B and 19.5 ml of 0.25% bupivacaine + 75 mcg of clonidine (0.5 ml) in Group C. Postoperatively, the patients’ haemodynamic status, visual analogue scale (VAS) scores, dose of rescue analgesic used, duration of analgesia were recorded. Inj. Tramadol 100 mg was given intravenously as rescue analgesic when the VAS score was more than four. Data were analyzed using unpaired t test and Mann- Whitney test wherever indicated.

Results: The heart rates recorded at 6, 8, 10, 12 and 14 hours after TAP block were significantly lower in Group C compared to Group B (p< 0.05). The heart rates recorded at 16 and18 hours after TAP block were significantly lower in Group B compared to Group C. The mean arterial pressures (MAP) and VAS scores recorded at 6 and 8 hours after TAP block were significantly lower in Group C compared to Group B. The mean dose of tramadol administered was significantly lower in Group 96.67±18.25 mg) compared to Group B (186.67±34.57 mg) (p value 0.0001). The mean duration of analgesia was significantly higher in Group C (943.46±70.751 minutes) compared to Group B (413.20±45.023 minutes, p value 0.001).

Conclusion: Addition of clonidine to 0.25% bupivacaine for TAP block significantly prolongs the duration of analgesia and reduces postoperative analgesic requirements compared to patients receiving 0.25% bupivacaine alone.