EFFECT OF ORAL CLONIDINE PREMEDICATION ON THE DURATION OF ANALGESIA PRODUCED BY SPINAL BUPIVACAINE.

Abstract

The concept of “pre-emptive analgesia” is becoming popular and the use of clonidine along with regional techniques is one of the important milestones in post-operative pain management. The aim of our study is to assess the effects of oral clonidine premedication on the duration of analgesia by bupivacaine subarachnoid block. Its a randomized controlled trial involving one hundred American Society of Anesthesiologists (ASA) graded assessment of risk status I & II patients, aged 20 – 50 years undergoing various elective lower abdominal and lower limb surgeries in a tertiary medical care institute. The study group was divided into two groups of 50 patients each. Group A patients received no premedication and Group B received 100μcg of oral clonidine two hours prior to spinal anaesthesia. Both groups received 3ml of 0.5% Bupivacaine (heavy) for spinal anaesthesia using 25 gauge quincke spinal needles and sensory blockade attained was T₆. Hemodynamic parameters were monitored before, during and after the procedure. Time for onset of sensory and motor blockade, duration of maximum motor blockade, duration of postoperative analgesia and the incidence of complications were recorded and compared between the two groups. Clonidine prolonged the mean duration of motor blockade by 160.8 ± 29.88 min compared to 106.6 ± 9.11 min by control group (P < 0.05). The mean duration of analgesia was 183.30 ± 20.21 min in clonidine group compared to 115.9 ± 12.4 min in control group (P < 0.05) and the difference was found to be statistically significant. No significant difference was found on demographic data, hemodynamic parameters, and frequency of complications. 100μg oral Clonidine two hours prior to bupivacaine subarachnoid block prolongs the duration of post-operative analgesia.