Effects of low Doses of Intrathecal Clonidine and Dexmedetomidine with Bupivacaine on The Duration of Sensory and Motor Block in Abdominal and Lower Limb Surgeries- A Prospective Randomised Double Blinded Study

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  • Effects of low Doses of Intrathecal Clonidine and Dexmedetomidine with Bupivacaine on The Duration of Sensory and Motor Block in Abdominal and Lower Limb Surgeries- A Prospective Randomised Double Blinded Study

Effects of low Doses of Intrathecal Clonidine and Dexmedetomidine with Bupivacaine on The Duration of Sensory and Motor Block in Abdominal and Lower Limb Surgeries- A Prospective Randomised Double Blinded Study

1Dr P Lekha Priyadharshini, 2Dr V Jayaraman
1,2Department of Anesthesiology and Pain Medicine, Sri Ramachandra Institute of Higher Education and Research


ABSTRACT:

BACKGROUND: The purpose of this study is to compare the duration of sensory and motor block in  elective lower limb and abdominal procedures following intrathecal administration of bupivacaine along with adjuvants either clonidine or dexmedetomidine.
METHODS: A prospective randomised double blinded study. 120 study participants were randomly allocated to three groups-Group A was given 12.5 mg of hyperbaric bupivacaine, Group B was given 3 mcg dexmedetomidine along with 12.5 mg hyperbaric bupivacaine and Group C was given 30 mcg of clonidine along with hyperbaric bupivacaine. The duration of sensory and motor block was recorded. 
RESULTS: Group B and C study participants showed significantly longer duration of sensory and motor block when compared to Group A. The mean duration of sensory block in Group A was 92.5 minutes, Group B 124.5 minutes Group C (119.4 minutes) (A vs B, A vs C p<0.001). The mean duration of motor block in group A 149.1 min, group B 252.5 min, Group C 217 min (A vs B, A vs C, B vs C P<0.001)
CONCLUSION: By adding 3 mcg dexmedetomidine or 30 mcg clonidine to hyperbaric bupivacaine duration of sensory and motor block was significantly prolonged.

 

REFERENCES :

1) Gordh T Jr, Post C, Olsson Y. Evaluation of the toxicity of subarachnoid clonidine, guanfacine, and a substance Pantagonist on rat spinal cord and nerve roots: light and electron microscopic observations after chronic intrathecal administration. Anesth Analg 1986; 65 (12): 1303—11
2) Strebel S, Gurzeler J, Schneider M, Aeschbach A, Kindler C. Small-dose intrathecal clonidine and isobaric bupivacaine for orthopedic surgery: a dose—response-study. Anesth Analg 2004; 99: 1231—8
3) Dobrydnjov I, Axelsson K, Thorn S-E, et al. Clonidine combined with small-dose bupivacaine during spinal anesthesia for inguinal herniorrhaphy: a randomized double- blinded study. Anesth Analg 2003; 96: 1496—503.
4) Dobrydnjov I, Axelsson K, Samarutel J, Holmstrom B. Postoperative pain relief following intrathecal bupivacaine combined with intrathecal or oral clonidine. Acta Anaesthesiol Scand 2002; 46: 806—14
5) Kanazi GE, Aouad MT, Jabbour-Khoury SI, Al JazzarMD,Alamedine MM, Al- yaman R, et al. effect of low dose dexmedetomidine or clonidine on the characteristics of spinal block. Acta Anaesthesiolscand. 2006;50:222-7
6) Saxena H, Singh SK, Ghildiyal S. Low dose intrathecal clonidine with bupivacaine improves onset and duration of block with haemodynamic stability. The Internet Journal of Anaesthesiology 2010;23:1.TJ
7) Al-Ghanem SM, Massad IM, Al-Mustafa MM, Al-Zaben KR, Qudaisat IY, Qatawneh AM, et al. Effect of Adding Dexmedetomidine versus Fentanyl to Intrathecal Bupivacaine Anaesthesiology and Pain Medicine Reg. No. M2320018 on Spinal Block Characteristics in Gynecological Procedures: A Double blind Controlled Study. American Journal of Applied Sciences 2009;6(5):882-7.
8) Gupta R, Bogra J, Verma R, Kohli M, Kushwaha JK, Kumar S. Dexmedetomidine as an intrathecal adjuvant for postoperative analgesia. Indian J Anaesth 2011;55(4):347 -51
9) Eid HEA, Shafie MA, Youssef H. Dose -Related Prolongation of Hyperbaric Bupivacaine Spinal Anesthesia by Dexmedetomidine. Ain Shams Journal of Anesthesiology 2011 Jul;4(2):83-95.
10) De Kock Marc, Gautier, Philippe, Fanard, Luc Hody, Jean, LavandHomme, Patricia: Intrathecalropivacaine and clonidine for ambulatory knee arthroscopy: A dose responses duty Anesthesiology:April 2004;94:574-578.
11) Al-Mustafa MM, Abu-Halaweb SA, Aloweidi AS, Mursbidi MM, Ammari BA, Awawad ZM, et al. Effect of Dexmedetomidine added to spinal Bupivacaine for Urological procedures. Saudi Med J 2009;30(3):365 -70
12) Shukla D, Verma A, Agarwal A, Pandey HD, Tyagi C. Comparative study of intrathecal dexmedetomidine with intrathecal magnesium sulfate used as adjuvan ts to bupivacaine. J AnaesthClinPharmacol 2011;27:495 -9.
13) Sethi BS, Samuel M, Sreevastava D. Efficacy of Analgesic effects of low dose intrathecal clonidine as adjuvant to bupivacaine. Indian Journal of Anaesthesia 2007;51 (5):415 -9.
14) Kaabachi O, Zarghouni A, Ouezini R, Abdelaziz AB, Chattaoui O, Kokki H. Clonidine 1 mg/kg is a safe and effective adjuvant to plain bupivacaine in spinal anesthesia in adolescents

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