title: Comparison of clonidine and fentanyl as adjuvant to ropivacaine in spinal anesthesia in lower abdominal surgeries.
abstract: BACKGROUND
  Ropivacaine, a newer local anesthetic, is gaining increased acceptance due to its improved safety profile over bupivacaine and lignocaine. Analgesic adjuvants have proved to be valuable in improving the quality of anesthesia and duration of analgesia.
  
  
  OBJECTIVE
  To compare the efficacy of clonidine and fentanyl as adjuvants to ropivacaine in spinal anesthesia in lower abdominal surgeries.
  
  
  METHODS
  A randomized, double-blind control study was carried out in 100 patients who were randomly divided into two groups. Ropivacaine-clonidine group (RC) received 30 μg of clonidine with 18.75 mg of 0.75% isobaric ropivacaine, Ropivacaine-fentanyl group (RF) received 25 μg of fentanyl with 18.75 mg of 0.75% isobaric ropivacaine intrathecally. The onset and duration of sensory and motor block, hemodynamic parameters, quality of surgical analgesia, total analgesia time, sedation score, and side effects were statistically analyzed using SPSS statistical package, paired and unpairedt-tests and Chi-square test.
  
  
  RESULTS
  The duration of sensory block in RC (240.00 ± 20.99), RF (196.80 ± 18.34), and motor block in RC (192.20 ± 17.36), RF (139.20 ± 17.93) outlasted the duration of surgery. In clonidine group, there was significant prolongation of sensory block, motor block and the total analgesia time. Hypotension and bradycardia occurred more commonly in RC group, whereas pruritus was more in RF group.
  
  
  CONCLUSIONS
  Ropivacaine when combined with either clonidine or fentanyl provided an adequate subarachnoid block for lower abdominal surgeries. As an adjuvant, clonidine has advantage over fentanyl as it increased the duration of the subarachnoid block and the postoperative analgesia.
authors.affiliation: Department of Anaesthesia, Government Medical College, Amritsar, Punjab, India.
authors.forename: Radhe
authors.initials: R
authors.lastname: Sharan
authors.affiliation: Department of Anaesthesia, Government Medical College, Amritsar, Punjab, India.
authors.forename: Rajan
authors.initials: R
authors.lastname: Verma
authors.affiliation: Department of Anaesthesia, Government Medical College, Amritsar, Punjab, India.
authors.forename: Akshay
authors.initials: A
authors.lastname: Dhawan
authors.affiliation: Department of Anaesthesia, Government Medical College, Amritsar, Punjab, India.
authors.forename: Jugal
authors.initials: J
authors.lastname: Kumar
keywords: Anesthesia spinal; anesthetics local; clonidine; fentanyl; ropivacaine