Clinical evaluation of dexmedetomidine versus clonidine as an adjuvant to bupivacaine in subarachnoid block for gynecological procedure
A prospective, randomized, double blind, controlled study
Keywords:
clonidine, dexmedetomidine, hyperbaric bupivacaine, motor blockAbstract
Background and Aim: Clonidine is a partial α2 adrenergic agonist used intrathecally with well-established efficacy and safety profile with effective prolongation of both motor and sensory spinal blockade. Dexmedetomidine, another member of α2 agonist’s family, is recently being introduced in Indian market and is approved as an intravenous sedative and co-analgesic drug. This study examines and compares the usefulness and safety of dexmedetomidine versus clonidine as an adjuvant to bupivacaine in subarachnoid block for gynecological vaginal surgeries. Material and Methods: Hundred patients, aged 30-60 years of ASA Physical status I and II, scheduled for elective gynecological vaginal surgery were enrolled in this study. Patients were randomly allocated to one of the two groups of 50 patients each by distributing sealed envelopes. Group C (n=50) received 0.5% hyperbaric Bupivacaine 2.5ml + 0.5ml distilled water containing 30µgm clonidine intrathecally. Group D (n=50) received 0.5% hyperbaric Bupivacaine 2.5ml +0.5ml distilled water containing 5µg Dexmedetomidine intrathecally. The sensory block was assessed by skin sensation to pin prick. The motor block was assessed according to the Modified Bromage Scale. Hemodynamic variables were recorded at 1, 3, 5, 10, 15, 20, 30 minutes and then at 15 minutes interval throughout the surgical period.
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