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Indian Journal of Anesthesia and Analgesia

Volume  6, Issue 1, Jan-Feb 2019, Pages 241-248
 

Original Article

A Randomised Prospective Double Blinded Study of Intrathecal Levobupivacaine with Fentanyl Verses Clonidine for Infraumblical Surgeries

Greeshma N Murdeshwar1, HG Manjunath2, Somashekara SP3

1Assisstant Professor 2Professor and Head 3Post Graduate Student, Department of Anaesthesia, Mysore Medical College And Research Institute, Mysore, Karnataka 570001, India.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6119.34

Abstract

Background and aims: Subarachnoid block can be performed with many local anaesthetic agents. Besides hyperbaric bupivacaine even isobaric levobupivacaine and ropivacaine can also be used with minimal cardiotoxicity. Adjuvants like opiods and alpha-2 agonist prolongs the duration of levobupivacaine action. The aim of the present study is to compare fentanyl and clonidine effect used as adjuvants to levobupivacaine with respect to onset of sensory and motor blockade; maximum level attained and the required for the same; duration of blockade and post operative analgesia. Materials and Methods: After ethical committee approval, 80 patients posted for infraumblical surgeries divided into two groups. Group LF received 15 mg of levobpivacaine with 25µg fentanyl whereas group LC received 15 mg of levobupivacaine with 30µg clonidine. The volume of solution was 3.5 ml in both groups. Hemodynamic, sensory and motor characteristics were monitored. Results: Onset of sensory and motor blockade as well as regression of both was faster with fentanyl than clonidine. There was slight fall in heart rate and mean arterial pressure in both the groups after intrathecal drugs but it was more with clonidine. Bradycardia and hypotension was noted more with clonidine than fentanyl which was easily manageable. Though the onset was delayed, sensory, motor and analgesic effect was prolonged with clonidine. Conclusion: Levobpiacaine can be safely used for spinal anaesthesia in infraumblical surgeries. Adding fentanyl causes early onset of action whereas clonidine has more prolonged action.


Keywords : Levobupivacaine; fentanyl; clonidine; spinal anaesthesia.
Corresponding Author : HG Manjunath