Study Comparing the Effectiveness of Intrathecal Bupivacaine and Clonidine versus Bupivacaine and Dexmedetomedine for Gynaecological Procedures
European Journal of Molecular & Clinical Medicine,
2023, Volume 10, Issue 2, Pages 1828-1834
AbstractBackground and Aim: Various adjuvant are being used with local anesthetics for prolongation of intra operative and postoperative analgesia. Dexmedetomidine, a highly selective alpha-2adrenergic agonist, has emerged as a valuable adjunct to regional anesthesia and analgesia. The study was aimed to compare the onset, duration of sensory and motor block, hemodynamic effects, post-operative analgesia, and adverse effects of dexmedetomidine and clonidine with bupivacaine for spinal anesthesia.
Material and Methods: Present study was conducted at GMERS Medical College and Hospital, Vadnagar, Gujarat for the duration of 2 years and 1 month. A total of 80 numbers of patients belonging to American Society of Anesthesiology (ASA) Grades 1 and 2 scheduled for gynecological surgery under subarachnoid block were enrolled after obtaining approval from the Hospital Ethics Committee. The patients were allocated in two groups (40 each). Group I bupivacaine + clonidine (B+C) received 17.5 mg of bupivacaine supplemented 45 mcg clonidine and Group II bupivacaine + dexmedetomidine (B+D) received 17.5 mg bupivacaine supplemented 5 mcg dexmedetomidine. The onset time of sensory and motor level, time to reach peak sensory and motor level, hemodynamic changes and side effects were recorded.
Results: Mean time of onset of sensory block in Group I and Group II were found to be 3.69±0.12 mins and 2.14±0.01 mins respectively (p>0.05). The onset of motor block in Group I was slightly less (3.99±0.44 mins) than Group II (4.24±0.80 mins), however, the difference was insignificant. Duration of sensory and motor block was significantly prolonged in group I as compared to group II (p<0.05) The duration of spinal anesthesia was shorter in group I as compared to group II (p<0.05)
Conclusion: The use of intrathecal dexmedetomidine as an adjuvant to bupivacaine seems to be an attractive alternative to clonidine for long duration gynecological surgical procedures due to its profound intrathecal anesthetic and analgesic properties combined with minimal side effects.
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