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Indian Journal of Anesthesia and Analgesia

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Clonidine, Fentanyl and Bupurenorphine as an Adjuvant Agent to Bupivacaine in LSCS Cases

Yedidi Samyukta, Assistant Professor, Department of Anesthesiology, Pain medicine & Critical care, SreeBalaji Medical College & Hospital CLC works road, Chromepet, Chennai-600044, Tamil Nadu, India. , Meera Rani Nayak1 , Yedidi Samyukta2 , Bhagyavardhan Botta3

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Indian Journal of Anesthesia and Analgesia 4(3):p 827-832, July - September 2017. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4317.45

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Abstract

Context: Various additives are mixed with local anaesthetic agents to increase the quality of block in spinal anesthesia. We want to compare quality at low doses and effective adjuvant among them. Aims: Comparing the efficacy of lowest possible doses of clonidine, fentanyl and buprenorphine with minimal side effects by evaluating onset and duration of sensory and motor block, when added as adjuvants to bupivacaine in patients posted for caesarean section under spinal anaesthesia. Settings and Design: Prospective randomized and comparative study of 60 ASA I and II patients undergoing LSCS under spinal anaesthesia. Methods and Material: Patients were randomly allotted into 3 groups(n=20). Group BC received 1.8ml of 0.5% injection hyperbaric bupivacaine with 30 µg (0.2ml) of Clonidine. Group BF received 1.8ml of 0.5% injection hyperbaric bupivacaine with 20µg (0.2ml) of fentanyl. Group BB received 1.8ml of 0.5% injection hyperbaric bupivacaine with 60µg (0.2ml) of buprenorphine. Statistical Analysis Used: For categorical data chi-square test and continuous data was compared using ANNOVA test. Results: The onset of motor blockade was faster in Clonidine group. The duration of block and post-operative analgesia were prolonged in BC when compared to BB and BF (P <0.001). No significant difference noted in the onset time of sensory block. Clonidine 30µg is optimal low dose for LSCS cases without causing much hemodynamic variation and sedation. Conclusions: Intrathecal Clonidin 30µg is an effective spinal adjuvant when compared to 20µg fentanyl or buprenorphine 60µg in LSCS patients with better haemodynamic stability, no sedation with nil side effects.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4317.45

Keywords

Fentanyl; Buprenorphine; Clonidine; LSCS; Subarachnoid Block. 

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