Comparative study of the effects of intrathecal clonidine and fentanyl as adjuvant with low dose hyperbaric bupivacaine for unilateral spinal anaesthesia in lower limb surgery

Abstract

Background and Aims: Unilateral Spinal anaesthesia with bupivacaine is administered for lower limb surgeries. The aim of the study is to compare between the effects of Clonidine and Fentanyl when added as an adjuvant to low dose bupivacaine in unilateral spinal anaesthesia in lower limb surgery on the basis of onset and duration of sensory and motor blockade and post-operative analgesia. Material & Methods: After obtaining the institutional ethics committee approval total 150 patients ofeither sexbetween 18 to 55 years of age, American Society of Anaesthesiology (ASA) I and II scheduled for elective lower limb surgery were divided into three groups. All patients received 0.5% hyperbaric bupivacaine (7.5mg) 1.5ml intrathecally along with ± adjuvant ( In Group A - clonidine (30 microgram) 0.2 ml diluted with normal saline to make 0.5 ml, Group B- fentanyl 25 microgram or 0.5 ml, Group C only 0.5ml normal saline) to make total 2ml solution . The results of observations were tabulated, compiled and statistically analysed using SPSS (version) 25.0 and Graph Pad prism version 5. Result : Fentanyl and clonidine both when added to low dose bupivacaine in unilateral spinal anaesthesia prolonged the duration of sensory and motor block compared to only low dose local anaesthetic agent. The time duration before the use of first dose of rescue analgesic is more prolonged in the group receiving clonidine as compared to Fentanyl group patient.