title: Comparative Efficacy of Intrathecal Bupivacaine Alone and Combination of Bupivacaine with Clonidine in Spinal Anaesthesia.
abstract: BACKGROUND
  Clonidine is an α2 agonist agent that has been used as an adjuvant to local anaesthetics in regional anaesthesia.
  
  
  OBJECTIVE
  This study compared two combinations of bupivacaine and clonidine with bupivacaine alone for surgeries below the level of umbilicus in spinal anaesthesia.
  
  
  METHODS
  We conducted a randomized double blind study on 90 patients of ASA I and ASA II aged 20-60 years, 30 in each group, undergoing surgery below the level of umbilicus in spinal anaesthesia. For intrathecal block, Group 1 received bupivacaine hydrochloride 12.5mg (2.5ml) in 8% dextrose (0.5% sensorcaine heavy) + 1ml (150μg) of preservative free clonidine. Group 2 received bupivacaine hydrochloride 12.5mg (2.5ml) in dextrose (0.5% sensorcaine heavy) + 0.5ml (75μg) of preservative free clonidine + 0.5ml of normal saline to make the volumes of all the groups same. Group 3 received bupivacaine hydrochloride 2.5ml in 8% dextrose (0.5% sensorcaine heavy) + 1ml of normal saline to make the volumes of all the groups same. Heart rate, NIBP, oxygen saturation and respiratory rate were monitored. The onset and duration of sensory block, the highest dermatomal level of sensory block, motor block, time to complete motor block recovery and duration of spinal anaesthesia were recorded.
  
  
  METHODS
  The data of the study was recorded in the record chart and results were evaluated using statistical tests (ANOVA test, post-hoc turkey hsd test, paired t-test and chi-square test).
  
  
  RESULTS
  Demographic data, the incidence and duration of bradycardia were comparable amongst the groups. The duration of sensory and motor block were greatest in group 1, followed by group 2 and group 3 (p <0.01). Decrease in the systolic blood pressure of group 2 and group 3 was noted as compared to group 1. No significant sedation or respiratory depression was observed in any group.
  
  
  CONCLUSIONS
  Addition of clonidine to bupivacaine intrathecally is although a reliable method to prolong spinal anaesthesia but close monitoring for hypotension is desirable.
authors.affiliation: Assistant Professor, Department of Neuroanaesthesia, MMIMSR , Mullana, Ambala, Haryana, India .
authors.forename: Ajay
authors.initials: A
authors.lastname: Wahi
authors.affiliation: Assistant Professor, Department of Community Medicine, MMIMSR , Mullana, Ambala, Haryana, India .
authors.forename: Amanjot K
authors.initials: AK
authors.lastname: Singh
authors.affiliation: Assistant Professor, Department of Anaesthesia, IGMC , Shimla, Himachal Pradesh, India .
authors.forename: Kartik
authors.initials: K
authors.lastname: Syal
authors.affiliation: Professor, Department of Anaesthesia, IGMC , Shimla, Himachal Pradesh, India .
authors.forename: Ajay
authors.initials: A
authors.lastname: Sood
authors.affiliation: Professor, Department of Anaesthesia, IGMC , Shimla, Himachal Pradesh, India .
authors.forename: Jyoti
authors.initials: J
authors.lastname: Pathania
keywords: ASA 1&2; Adjuvant; Bromage scale; Lower abdominal surgery; Subarachnoid block; α2 agonist