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Indian Journal of Anesthesia and Analgesia

Volume  6, Issue 2, March - April 2019, Pages 379-386
 

Original Article

Comparision of Intrathecal Fentanyl and Clonidine with 0.5% of Bupivacaine Heavy in Spinal Anaesthesia in Elderly Urological Surgeries

Amarjeet D. Patil1#, Vennel Jessy2, Bhumika Kathiriya3

1Ex-Assistant Professor, 2Associate Professor, 3Senior Registrar, Department of Anaesthesiology, MGM Medical College & Hospital, Kamothe, Navi Mumbai, Maharashtra 410209, India. #Presently - Honorary Lecturer, Faculty of Biology, Medicine and Health, The University of Manchester, Senior Clinical Fellow, Manchester University NHS Foundation Trust, Department of Anaesthesia and Critical Care, Manchester, M13 9WL, U.K.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6219.2

Abstract

Background: Lipophilic opioids (fentanyl) and alpha-2 agonist (clonidine) are increasingly being administered intrathecally as adjuncts. They enhance the effect of spinal anaesthesia without prolonging motor recovery and discharge time. Aims and objectives: To work out the influence of intrathecal fentanyl vs intrathecal clonidine with low dose (2.5 ml) bupivacaine in urological surgeries. Materials and methods: The study was a randomized, prospective study conductedas a double blind trial at the tertiary care hospital. Total 60 patients were included in this study, after fulfilling standard criteria. The study population have patients of either sex, ASA physical status I and II in the range of 50-70 years. Patients were randomly assigned to Fentanyl (F)group and Clonidine (C) group. They were assessed for analgesia time, complications, hemodynamic changes and sensory and motor block. Statistical tests: All the data was collected and entered in Microsoft Excel sheet and transferred to SPSS software ver.17 for analysis. Chi-Square test, unpaired student ‘t’ test and paired ‘t’ test wasused. P - Value of <0.05 was considered statistically significant and that of < 0.001 was considered statistically highly significant. Results: Time of onset of motor block (min) was significantly faster in group C (2.21 ± 0.6) as compared to group F (5.4 ± 0.8). Time of onset of sensory block (min) was significantly faster in group C (2.44 ± 0.5) as compared to group F (6.12 ± 0.7). Conclusion: The onset of sensory and motor blockade was faster with clonidine. Clonidine offered good post-operative analgesia. Fentanyl may be a better choice for surgeries requiring minimal hospital stay.


Keywords : Intrathecal Anaesthesia, Bupivacaine, Fentanyl, Clonidine, Urological, Surgeries.
Corresponding Author : Amarjeet D. Pati