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

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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.

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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.

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This page is a summary of: Comparative Evaluation of the Role of 0.5% Hyperbaric Bupivacaine with and without Clonidine under Spinal Anesthesia, Indian Journal of Anaesthesia and Analgesia, January 2019, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.6419.51.
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