A PROSPECTIVE COMPARATIVE CLINICAL STUDY TO EVALUATE ORAL CLONIDINE AS A PREMEDICATION WITH 0.5% HYPERBARIC BUPIVACAINE & 0.5% HYPERBARIC BUPIVACAINE ALONE IN SPINAL ANAESTHESIA FOR PATIENTS UNDER GOING ELECTIVE LOWER ABDOMINAL AND LOWER LIMB SURGERIES.

BACKGROUND:-Spinal anesthesia is the most common technique used for lower abdominal surgeries. The concept of pre-emptive analgesia has been becoming popular and use of clonidine along with regional techniques is one of important milestones in post-operative pain management. Hyperbaric Bupivacaine has limited duration of action. Clonidine has been used to prolong duration of local anesthetic. Hence in our study, we studied effect of oral clonidine premedication on spinal anesthesia with hyperbaric bupivacaine with reference to onset and duration of sensory and motor block, duration of analgesia, sedation and including its effect on haemodynamic status. METHODS:-Sixty patients of ASA grade I and II posted for elective surgeons under spinal anesthesia were selected. For this, prospective double blind study group received 150 microgram of oral clonidine, 90 minutes before spinal anesthesia. Spinal anesthesia was given with 3 ml of 0.5 % hyperbaric bupivacaine. Group P (control group) received sweetener tablet 90 minutes prior to spinal anesthesia. RESULTS:-It was observed that clonidine as a premedication has no effect on the onset of sensory and motor block. Clonidine significantly prolonged duration of sensory and motor block (p<0.001). Duration of analgesia was also significantly prolonged in clonidine group (p<0.001). Clonidine at a dose of 150µcg is not associated with any major change in heart rate and blood pressure following spinal anesthesia. As compared to control group, Clonidine results in higher incidence of moderate sedation. Conclusion:-We conclude that oral clonidine premedication in patients with hyperbaric bupivacaine prolong duration of sensory and motor block, also prolongs duration of analgesia and provides moderate sedation.