A Comparative Study of Intrathecal Clonidine and Intrathecal tramadol for Prolongation of Neuraxial blockade analgesia with 0.5% Bupivacaine in lower limb surgeries

Abstract

Background: Clonidine, a selective partial a2 -adrenergic agonist, is being extensively evaluated as an adjuvant to intrathecal local anaesthetics and has proven to be a potent analgesic free of opioid-related side effects. Objectives: To Compare Intrathecal Clonidine and Intrathecal tramadol for Prolongation of Neuraxial blockade analgesia with 0.5% Bupivacaine in lower limb surgeries. Methods: This study was done in a prospective double blinded randomized manner. Group A (N-25): Received Clonidine hydrochloride (0.25ml) 37.5 mcg and 0.5% Hyperbaric Bupivacaine hydrochloride (3 ml) + 0.75 ml Normal saline. (Total 4 ml). Group B (N-25): Received Tramadol (0.5ml) 25mg and 0.5% Hyperbaric Bupivacaine hydrochloride (3 ml) + 0.5 ml Normal saline. (Total 4 ml). Results: There is no significant difference between the groups in Time to Full Motor to Recovery. There is significant difference in VAS Score at 180 & 240 Minutes. There is significant difference in Bromage Score at 120 & 300 Minutes. There is no significant difference in heart rate between the two groups. Conclusion: Addition of clonidine 37.5 mcg (0.25ml) to 0.5% hyperbaric bupivacaine intrathecally produced faster onset of sensory analgesia and longer duration of analgesia when compared to tramadol without any prolongation in time to full motor recovery and without significant haemodynamic changes or adverse effects.

Keywords

• clonidine
• bupivacaine
• hemodyanamic changes