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International Journal of Recent Trends in Science and Technology, ISSN 2277-2812 E-ISSN: 2249-8109
Volume 11, Issue 3, July 2014 pp 418-421
Comparison of the effects of intrathecal dexmedetomidine, intrathecal clonidine as spinal adjuvants for lower limb and lower abdominal surgeries
Pradeep A Dongare1, S. S. Nethra2, K. Sudheesh3, P. Prabha4, Devika Rani D.5, M. Sathesha6
1Senior Resident, 2Professor, 3Associate Professor, 4Associate Professor, 5Associate Professor, 6Assistant Professor, Department of Anaesthesiology, Bangalore Medical College and Research Institute, Bangalore-560002, INDIA.
Context: Lower limb and lower abdominal surgeries are usually performed under spinal anesthesia. α2 agonists, like clonidine and dexmedetomidine are said to prolong the action of local anesthetics when administered intrathecally. Aims: To investigate the effect of intrathecal administration of dexmedetomidine or clonidine on sensory, motor block and hemodynamic parameters. Settings and Design: Prospective Randomised Controlled Double Blind study. Methods and Material: 150 patients were randomly allocated into three groups. Patients in Group A received 2ml of hyperbaric bupivacaine + 5 μg dexmedetomidine in 1 ml normal saline, Group B received 2 ml of hyperbaric bupivacaine + 50 μg of clonidine in 1 ml normal saline and Group C received 2 ml of hyperbaric bupivacaine + 1 ml normal saline Results: Duration of sensory blockade was significantly prolonged in Group A (317.2± 90.27 minutes) and Group B (291.9± 82.63 minutes) when compared to Group C (204.26± 84.77 minutes). The median cephalad spread of the drug was T8 in Group A (Range T 4-T10), T6 in Group B (Range T2-T10) and T10 in Group C (Range T6-T12). The regression of motor blockade to Bromage score 0 was comparable between Group A and B but was significantly prolonged in comparison to Group C (Group A-323.14±93.43, Group B-296.31± 94.67 and Group C-206.98± 88.00). Conclusions: Intrathecaldexmedetomidine is comparable to intrathecal clonidine and prolongs the duration of motor and sensory blockade with minimal side effects.