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Randomized control trial with intravenous dexmedetomidine and intravenous clonidine using bupivacaine in spinal anesthesia in lower abdominal surgeries

 Department of Anaesthesia, Sri Siddhartha Medical College, Tumkur, Karnataka, India

Correspondence Address:
T. K. Krishna Murthy,
Kuvempu Nagar, Gubbi, Tumkur - 572 216, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/aer.AER_8_20

Background: In recent years, several adjuvants have been used to prolong the duration of the subarachnoid block. These adjuvants have either been used via intrathecal route or intravenous route. Dexmedetomidine and clonidine have been used as adjuvants to local anesthetic drugs by intrathecal, epidural, caudal, intravenous routes, and for peripheral nerve blocks. In this study, we endeavored at finding the efficacy of dexmedetomidine and clonidine in improving the analgesia quality and duration of the subarachnoid block. Setting and Design: A prospective double-blind randomized control trial comprising seventy patients posted for elective lower abdominal surgeries. Materials and Methods: Seventy patients were selected at random and were allocated to two groups of 35 each. In Group C, the patients received 0.5% hyperbaric bupivacaine with Clonidine 1.0 μ−1 intravenously. In Group D, the patients received 0.5% hyperbaric bupivacaine with Dexmedetomidine 0.5 μ−1 intravenously. Perioperatively, heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, and oxygen saturation were recorded and documented every 5 min till the end of surgery. Time of onset, level of sensory blockade, and duration of the sensory blockade were recorded. Motor block was assessed using the Modified Bromage scale. Data validation and analysis were carried out using the SPSS version 11. All the values ofP < 0.05 were considered statistically significant. Results: Time of onset of sensory blockade in the clonidine group was 3.46 ± 1.13 min and in the dexmedetomidine group was 2.93 ± 1.34 min (P < 0.05). The time of onset of motor block in the clonidine group was 4.17 ± 1.62 and in the dexmedetomidine group was 3.67 ± 1.51 min (P < 0.05). Time for two segment regressions of sensory block in clonidine group was 128.67 ± 14.53 min and in dexmedetomidine group was 136.31 ± 12.54 min (P < 0.05). Time of regression of motor block to the Modified Bromage Level 1 in clonidine group was 148.76 ± 19.65 min and in dexmedetomidine group was 145.76 ± 15.37 min (P < 0.05). Conclusion: The use of intravenous dexmedetomidine perioperatively prolongs the duration of sensory and motor block significantly when compared to intravenous clonidine.

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