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Indian Journal of Anesthesia and Analgesia

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Comparative Evaluation of Hyperbaric 0.5% Bupivacaine-Clonidine and only 0.5% Bupivacaine for Spinal Anaesthesia

Satish Deshpande*** , Rahul Kore* , Vinayak Sirsat** , Satish Deshpande***

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Indian Journal of Anesthesia and Analgesia 4(2):p 283-293, April - June 2017. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4217.18

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Abstract

 Pain of any kind is distressing to the life style of human being and relief of pain becomes mandatory all the time. Intraoperative as well as postoperative pain is of concern as it results in morbidity and mortality. Postoperative pain relief is beneficial in al aspects and hence efforts have been going on to introduce new techniques or newer drugs to relieve pain. Intrathecal use of adjuvant with conventional local anaesthetic agents has proved to be beneficial in this regard. Clonidine is an imidazoline derivative with 2 adrenergic agonist activity has analgesic effect at spinal level mediated by post­synoptically situated 2 adreno­receptors in dorsal horn of spinal cord. It has intrinsic analgesic effect to control postoperative pain with potentiating quality of subarachnoid block. 100 patients of either sex were divided into 2 equal groups. In group A 0.5% Bupivacaine 3cc with normal saline was administered and in group B 0.5% Bupivacaine 3 cc with 30 µgm of Clonidine with normal saline was administered intrathecally. It was observed that, in Clonidine group, the onset of sensory block, highest dermatome level, onset of motor block, duration of sensory block, duration of motor block, time for 2 segment regression of sensory block, total duration of surgical anaesthesia, quality of sensory and motor block sedation score, requirement of analgesic supplementation was superior in Clonidine group as compare to control group. The haemodynamic parameters as mean changes in pulse rate and systolic blood pressure and incidence of intraoperative and postoperative complications was negligible in both groups. Thus it was concluded that, intrathecal Clonidine is efficient adjuvant along with 0.5% Bupivacaine intrathecally as it improves the quality of sensory block and provides satisfactory prolonged postoperative analgesia with haemodynamic stability and minimum side effects. It is recommended to use Clonidine along with local anaesthetic intrathecally for lower abdominal surgeries requiring postoperative pain relief.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4217.18

Keywords

Subarachnoid Block; 0.5% Bupivacaine; Adjuvant; Inj. Clonidine; Duration and Quality of Block.

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