DOI: 10.36347/sjams.2018.v06i02.059

Pages: 765-772

Many adjuvants are being tried with local anaesthetics for prolongation of intra-operative and post-operative analgesia. Dexmedetomidine, the highly selective alpha2 adrenergic agonist is a newer neuraxial adjuvant gaining popularity nowadays. The purpose of this study was to compare the onset, duration of sensory motor blockade, hemodynamic effects and adverse effect of dexmedetomidine, clonidine with bupivacaine and bupivacaine with normal saline for spinal anaesthesia. The study was conducted in prospective, controlled randomized, double blind manner after approval from hospital ethical committee with written and informed consent of the patients. The patients were randomly allocated into three groups (30 patients each). 15 mg of hyperbaric bupivacaine was given to all patients with normal saline to group N, with 30 µg clonidine to group C and with 5 µg dexmedetomidine to group D patients .The onset time, regression time and peak levels of sensory and motor blockade, hemodynamic changes and side effects were recorded. Patients in group D had significantly longer duration of sensory and motor blockade than patients of group C and N. Mean duration of analgesia among the group N, D and C was 211.1±30.47, 386.83±58.43 and 296.53±57.19 minutes respectively (p <0.001). The regression time of motor blockade to reach modified bromage scale to zero was 181.03±20.83, 253.37±48.87 and 269.77±51.95 minutes in group N, D and C respectively (p<0.001). The difference in onset time and mean peak sensory level between three groups was statistically not significant (p>0.05). There was no significant sedation and hemodynamic variability between three groups. Intrathecal dexmedetomidine is associated with prolonged and sensory and motor block in comparison of clonidine. In low dose of dexmedetomidine and clonidine used for spinal anaesthesia in our study have minimal hemodynamic instability and does not cause any sedation intraoperative and post-operatively.