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Indian Journal of Anesthesia and Analgesia

Volume  6, Issue 4, July-August 2019, Pages 1428-1433
 

Original Article

Comparative Evaluation of the Role of 0.5% Hyperbaric Bupivacaine with and without Clonidine under Spinal Anesthesia

Ashwini T1, Subash S2, Ananda Bhat3

1,3Associate Professor, Department of Anesthesiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka 560069, India. 2Consultant, Cardiac Anesthesiologist, Department of Anesthesia, Kerala Institute of Medical science Trivandrum, Kerala 695029, India.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6419.51

Abstract

Background: Among the various modalities of regional anesthesia, spinal anesthesia is widely practiced. Clonidine is of interest because it preserves cardiovascular reflexes, provides sedation, greater intra operative haemodynamic stability and a reduction in anaesthetic and postoperative analgesics requirements and also has a marked opioid sparing effect. This study was carried out to compare the hemodynamic parameters between 0.5% hyperbaric Bupivacaine with and without Clonidine at various doses. Methods: This double blind randomized controlled trial was carried out in a total of 60 patients of age group 20 to 60 years of ASA grade I and II undergoing gynaecological and other lower abdominal surgery under spinal anesthesia. The control group consisted of 15 mg 0.5% hyperbaric bupivacaine while the experimental group was further classified into three groups based on the additional dosage of Clonidine. Presence of hypotension and bradycardia was documented. Results: Bradycardia was present in 73.3% of the participants in group IV while it was nil in Group I (controls). Hypotension was present in 73.3% of the participants in group IV while it was absent in group I participants. There was a statistically significant difference in the hypotension between group I & III, I & IV and II & IV (p<0.05). Conclusion: our study demonstrates that intrathecal clonidine at the usual dose of 1μg/kg is associated with bradycardia and relative hypotension. Therefore, 0.75 μg/Kg of clonidine is the preferred dose for addition to 0.5% hyperbaric bupivacaine in patients undergoing gynaecological and lower abdominal surgeries.


Keywords : Bradycardia; Clonidine; Hyperbaric bupivacaine; Hypotension; Spinal anesthesia.
Corresponding Author : Ananda Bhat