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Comparative Evaluation of Intrathecal Administration of Preservative-free Levobupivacaine Alone
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Why is it important?
Introduction: This study was done to look for the onset of effect and hemodynamic alterations with levobupivacaine in spinal anesthesia and to compare the effect of clonidine on onset and duration of levobupivacaine when given intrathecally in two different doses. Adverse effects and complications associated with the use of above drugs were also studied. Material and Methods: 75ASA I-II patients with age group 18-60 years undergoing infraumbilical surgeries were randomized to one of the three groups. Patients in Group 1 (L) received 15 mg (3.0 ml of 0.5%) preservative free levobupivacaine with 0.4 ml normal saline. Patients in group 2 (LC1) received 15 mg (3.0 ml of 0.5%) levobupivacaine with clonidine 30 μg (0.2 ml) and 0.2 ml normal saline. Group 3 (LC2) received 15 mg (3.0 ml of 0.5%) levobupivacaine with clonidine 60 μg (0.4 ml). Onset and duration of sensory and motor block, maximum sensory level achieved, sedation levels, hemodynamic parameters and adverse effects were recorded. Results: Clonidine significantly shortened the onset of sensory and motor block and prolonged the time to two segment regression and regression of motor block to modified Bromage 0. In addition group LC2 had higher sedation scores. There was higher incidence of hypotension, bradycardia and respiratory depression in group LC2. Conclusion: Intrathecal Clonidine in a dose of 30 μg significantly prolongs the anesthetic effects of intrathecal levobupivacaine without significant side effects. So, 30 μg is the preferred dose of clonidine over 60 μg, when used as an adjuvant to levobupivacaine in spinal anesthesia.
Perspectives
Introduction: This study was done to look for the onset of effect and hemodynamic alterations with levobupivacaine in spinal anesthesia and to compare the effect of clonidine on onset and duration of levobupivacaine when given intrathecally in two different doses. Adverse effects and complications associated with the use of above drugs were also studied. Material and Methods: 75ASA I-II patients with age group 18-60 years undergoing infraumbilical surgeries were randomized to one of the three groups. Patients in Group 1 (L) received 15 mg (3.0 ml of 0.5%) preservative free levobupivacaine with 0.4 ml normal saline. Patients in group 2 (LC1) received 15 mg (3.0 ml of 0.5%) levobupivacaine with clonidine 30 μg (0.2 ml) and 0.2 ml normal saline. Group 3 (LC2) received 15 mg (3.0 ml of 0.5%) levobupivacaine with clonidine 60 μg (0.4 ml). Onset and duration of sensory and motor block, maximum sensory level achieved, sedation levels, hemodynamic parameters and adverse effects were recorded. Results: Clonidine significantly shortened the onset of sensory and motor block and prolonged the time to two segment regression and regression of motor block to modified Bromage 0. In addition group LC2 had higher sedation scores. There was higher incidence of hypotension, bradycardia and respiratory depression in group LC2. Conclusion: Intrathecal Clonidine in a dose of 30 μg significantly prolongs the anesthetic effects of intrathecal levobupivacaine without significant side effects. So, 30 μg is the preferred dose of clonidine over 60 μg, when used as an adjuvant to levobupivacaine in spinal anesthesia.
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This page is a summary of: Comparative Evaluation of Intrathecal Administration of Preservative free Levobupivacaine Alone and with Clonidine in Different Doses in Patients Undergoing Infraumbilical Surgeries, Indian Journal of Anaesthesia and Analgesia, July 2020, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.7420.1.
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