title: A comparison between intrathecal clonidine and neostigmine as an adjuvant to bupivacaine in the subarachnoid block for elective abdominal hysterectomy operations: A prospective, double-blind and randomized controlled study.
abstract: OBJECTIVE
  Adjuvant to the local anesthetic agent has proven benefits when used intrathecally. With regards to intrathecal bupivacaine as control, we have compared in this study the effects of clonidine and neostigmine when co-administered intrathecally with hyperbaric (0.5%) bupivacaine for abdominal hysterectomy.
  
  
  METHODS
  This prospective, randomized, double-blind study was conducted from May 2009 to June 2011. A total of 150 patients of American Society of Anaesthesiology grades I and II scheduled for abdominal hysterectomy under spinal anesthesia were randomly allocated into three groups. A volume of 3 ml of 0.5% hyperbaric bupivacaine was respectively added 1 ml solution containing 5% dextrose and 75 mcg of neostigmine in Group N, 1 ml containing 5% dextrose and 30 mcg of clonidine in Group C and 1 ml of 5% dextrose in Group D (control). We compared the sensory and motor block, the surgical condition, the duration of spinal analgesia and the side-effect profile.
  
  
  RESULTS
  Sensory and motor blocks and duration of spinal analgesia were significantly increased in both Group C and Group N compared to Group D. More incidences of Nausea and vomiting were observed in Group N compared to other groups. The surgical condition was poorer in Group N compared to Group C.
  
  
  CONCLUSIONS
  Both intrathecal clonidine and neostigmine increase the bupivacaine-induced spinal block. However, clonidine provides better surgical condition and fewer incidences of nausea and vomiting.
authors.affiliation: Department of Anaesthesiology, Midnapore Medical College and Hospital, Midnapore, West Bengal, India.
authors.forename: D
authors.initials: D
authors.lastname: Bhar
authors.affiliation: Department of Anaesthesiology, Midnapore Medical College and Hospital, Midnapore, West Bengal, India.
authors.forename: S
authors.initials: S
authors.lastname: RoyBasunia
authors.affiliation: Department of Anaesthesiology, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India.
authors.forename: A
authors.initials: A
authors.lastname: Das
authors.affiliation: Department of Anaesthesiology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India.
authors.forename: S B
authors.initials: SB
authors.lastname: Kundu
authors.affiliation: Department of Gynecology and Obstetrics, Midnapore Medical College and Hospital, Midnapore, West Bengal, India.
authors.forename: R C
authors.initials: RC
authors.lastname: Mondal
authors.affiliation: Department of Anaesthesiology, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India.
authors.forename: P S
authors.initials: PS
authors.lastname: Halder
authors.affiliation: Department of Anaesthesiology, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India.
authors.forename: S K
authors.initials: SK
authors.lastname: Mandal
authors.affiliation: Department of Gynecology and Obstetrics, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India.
authors.forename: S
authors.initials: S
authors.lastname: Chattopadhyay
keywords: Abdominal hysterectomy; clonidine; intrathecal; neostigmine