title: Ultrasound-guided femoro-sciatic nerve block for post-operative analgesia after below knee orthopaedic surgeries under subarachnoid block: Comparison between clonidine and dexmedetomidine as adjuvants to levobupivacaine.
abstract: OBJECTIVE
  The advent of ultrasonographic-guided techniques has led to increased interest in femoro-sciatic nerve block (FSNB) for lower limb surgeries. α2-agonists have been used recently as adjuvants to local anaesthetics in nerve blocks. We aimed to compare equal doses of clonidine or dexmedetomidine as an adjuvant to levobupivacaine in FSNB for post-operative analgesia.
  
  
  METHODS
  Ninety patients scheduled to undergo below knee orthopaedic surgeries under subarachnoid block were divided into three groups: Group LL (n = 30) patients received 38 mL of 0.125% levobupivacaine with 2 mL normal saline, Group LD (n = 30) patients received 38 mL of 0.125% levobupivacaine with 0.5 μg/kg dexmedetomidine and Group LC (n = 30) received 38 mL of 0.125% levobupivacaine with 0.5 μg/kg clonidine in saline to make total drug volume of 40 mL. The primary and secondary outcome variables were duration of analgesia and rescue analgesic requirement, verbal rating score respectively. Continuous variables were analysed with analysis of variance or the Kruskal-Wallis test on the basis of data distribution. Categorical variables were analysed with the contingency table analysis and the Fisher's exact test.
  
  
  RESULTS
  Duration of analgesia was prolonged with dexmedetomidine (10.17 ± 2.40 h) and clonidine (7.31 ± 1.76 h) as compared to control (4.16 ± 1.04 h, P = 0.00). Significantly lower pain scores were observed in dexmedetomidine group as compared to clonidine up to 8 h post-operatively.
  
  
  CONCLUSIONS
  Equal doses of clonidine or dexmedetomidine added to levobupivacaine prolonged the duration of analgesia, decreased requirement of rescue analgesia. Dexmedetomidine delays the requirement of rescue analgesics with better pain scores as compared to clonidine.
authors: Department of Anaesthesia, Dr. Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh, India.
authors: Sudarshan Kumar
authors: SK
authors: Chaudhary
authors: Department of Anaesthesia, Dr. Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh, India.
authors: Ravinder Kumar
authors: RK
authors: Verma
authors: Department of Anaesthesia, Dr. Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh, India.
authors: Shelly
authors: S
authors: Rana
authors: Department of Anaesthesia, Dr. Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh, India.
authors: Jai
authors: J
authors: Singh
authors: Department of Anaesthesia, Dr. Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh, India.
authors: Bhanu
authors: B
authors: Gupta
authors: Department of Anaesthesia, Dr. Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh, India.
authors: Yuvraj
authors: Y
authors: Singh
keywords: Adjuvants; anaesthesia analgesia; dexmedetomidine hydrochloride; levobupivacaine; pain post-operative