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Intrathecal Bupivacaine vs Bupivacaine and Clonidine in Paediatrics Age Group: A Comparative Evaluation

Patil Pramod** , Jambure Nagesh* , Patil Pramod** , Wagh Rahul* , Deshmukh Ujjwal*

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Indian Journal of Anesthesia and Analgesia 2(1):p 29-37, Jan-Jun 2015. | DOI: https://dx.doi.org/10.21088/ijaa.2349.8471.2115.4

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Abstract

 Context: spinal anaesthesia is advantageous in that it uses small dose, simple to perform and offers a rapid onset of action, reliable surgical analgesia and good muscle relaxation. First report of paediatric spinal anaesthesia was published by August Bier in 1899 with Cocaine in 11 year old child for ischium abscess drainage. Aims: To compare the efficacy, duration, quality and side effects of intrathecal Bupivacaine alone and Bupivacaine plus clonidine in paediatric patients. Settings and Design: Patients were randomly allocated in two groups. Group-A received Bupivacaine 0.5% heavy (0.4mg/kg for 5-15kg or 0.3mg/kg for >15 kg) and Group-B received Bupivacaine 0.5% heavy (0.4mg/kg for 5-15kg or 0.3mg/kg for >15kg) and preservative free Clonidine (1 mcg/kg). Methods and Material: A prospective randomised double blind study was carried out in 60 ASA-1 paediatric patients undergoing surgeries below T8 dermatome up to 2 hrs duration. Patients were randomly allocated in two groups. Group- A and Group- B comprising 30 patients each. Time of onset of sensory block, maximum level of sensory block, duration of sensory block, duration of post-op analgesia and side effects were observed. Statistical analysis used: Data obtained was subjected to statistical computation and analysed using computer programme statistical package for social science (SPSS) ver-16.0 and test performed were unpaired student-t test, nonparametric mann-whitney two samples test and Chi square test. Value of p <0.05 was considered significant and p<0.0000001 highly significant. Results: addition of preservative free clonidine (1mcg/kg) to 0.5% hyperbaric Bupivacaine provides prolonged spinal anaesthesia, superior pain relief and better sedation without causing severe adverse effects compare to Bupivacaine alone. Conclusions: Clonidine is better adjuvant to Bupivacaine in spinal anaesthesia as far as patients comfort is concerned. It decreases the time taken for onset, produces longer duration of both surgical anaesthesia and postoperative analgesia and better quality of sedation with no added side effects as compare to Bupivacaine alone, in paediatric patients undergoing surgeries below T8 dermatome.

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DOI: https://dx.doi.org/10.21088/ijaa.2349.8471.2115.4

Keywords

Bupivacaine; Clonidine; Paediatric spinal.

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