Ajay Sharma1, Manoj Kumar Panwar2, Sofia Jaswal3, Ravikant Dogra4, Shweta Mahajan5, Vikas Jaswal6
1Senior Resident, 2Professor, 4,5Associate Professor, Department of Anesthesia and Critical Care, Indira Gandhi Medical College and Hospital, Shimla, Himachal Pradesh, 171001, 3Senior Resident, Department of Anesthesia and Critical Care, Ivy Hospital, Mohali, Punjab, 160071, 6Specialist Anesthesia, Department of Anesthesia, Civil Hospital, Jogindernagar, Himachal Pradesh, India.
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AbstractIntroduction: This study was done to look for the onset of effect and hemodynamic alterations with levobupivacaine in spinal anesthesia and to compare the effect of clonidine on onset and duration of levobupivacaine when given intrathecally in two different doses. Adverse effects and complications associated with the use of above drugs were also studied. Material and Methods: 75ASA I-II patients with age group 18-60 years undergoing infraumbilical surgeries were randomized to one of the three groups. Patients in Group 1 (L) received 15 mg (3.0 ml of 0.5%) preservative free levobupivacaine with 0.4 ml normal saline. Patients in group 2 (LC1) received 15 mg (3.0 ml of 0.5%) levobupivacaine with clonidine 30 μg (0.2 ml) and 0.2 ml normal saline. Group 3 (LC2) received 15 mg (3.0 ml of 0.5%) levobupivacaine with clonidine 60 μg (0.4 ml). Onset and duration of sensory and motor block, maximum sensory level achieved, sedation levels, hemodynamic parameters and adverse effects were recorded. Results: Clonidine significantly shortened the onset of sensory and motor block and prolonged the time to two segment regression and regression of motor block to modified Bromage 0. In addition group LC2 had higher sedation scores. There was higher incidence of hypotension, bradycardia and respiratory depression in group LC2. Conclusion: Intrathecal Clonidine in a dose of 30 μg significantly prolongs the anesthetic effects of intrathecal levobupivacaine without significant side effects. So, 30 μg is the preferred dose of clonidine over 60 μg, when used as an adjuvant to levobupivacaine in spinal anesthesia.
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