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Comparison of dexmedetomidine 5 mcg and clonidine 75 mcg added to 12.5 mg of 0.5% heavy bupivacaine for spinal anaesthesia in lower abdominal surgeries

Author: 
Dr. Prabhavathi, R., Dr. Sreenivasulu, A., Dr. Chaitanya Kumar, G., Dr. Narasimha Reddy, P., Dr. Vara Prasad, G. and Dr. Sujit, T.R.
Subject Area: 
Health Sciences
Abstract: 

Background: There are many adjuvants in the market which have been successfully used in combination with local anesthetics for intraop and postop analgesia.dexmededetomidine is a recent addition to the area of intensive care.it is a highly selective alpha 2 adrenergic agonist which is now gaining popularity as a new neuraxial adjuvant. Materials and Methods: sixty adult patients of ASA grade I-II were randomly divided into two groups of thirty each. Groups Clonidine (C), and Dexmeditomidine (D) received hyperbaric bupivacaine 0.5% 2.5 ml intrathecally with clonidine 75µg&dexmedetomidine 5 µg respectively. Hemodynamic data, degree of motor block (modified bromage scale), time to reach sensory block to L1 level, time for two segment regression of sensory block and time to reach modified bromage 0, total duration of analgesia were assessed. Results: Onset of motor block was delayed with group D as compared to group C .The difference was statistically insignificant (191.23 ± 98.04 sec in group D vs 171.75 ± 57.75sec in group C , p=0.001). Onset of sensory block was delayed with group C as compared to group D (83 ± 32.42 sec in group D Vs 115 ± 39.35 sec in group C, p=0.01 ). Dexmedetomidine produced significantly longer duration of sensory and motor block as compared to Clonidine. Regression time of sensory block was 374.34 ± 44.54 min for group D as compared to 302.5 ± 29.18 min for group C. Regression time to reach Bromage 1 was 317 ± 32 min for group D as compared to 220 ± 48 min for group C patients remained hemodynamically stable in both Dexmedetomidine and Clonidine groups. Conclusion: It can be concluded that though both clonidine and dexmedetomidine prolonged duration of sensory and motor block of bupivacaine, dexmedetomidine is better in terms of longer duration of action.

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