Abstract

Background: Subarachnoid blockade with local anaesthetics provide intense analgesia by segmental blockade of central neural axis but the duration is short lasting. Various drugs are administered intrathecally along with local anaesthetics to prolong the duration of action. Present study was aimed to study effects of intrathecal clonidine as an adjuvant with 0.5 % hyperbaric bupivacaine in vaginal hysterectomy under spinal anaesthesia at a tertiary hospital. Material and Methods: Present study was prospective, randomized double-blind, controlled, single center study, conducted in patients of age 45 – 65 years, normotensive, ASA grade I and II, scheduled for vaginal hysterectomy under spinal anaesthesia. Results: In this study 40 patients were enrolled. Hemodynamic variables (Pulse rate, systolic blood pressure & diastolic blood pressure) were studied. In present study, we noted that duration of onset to peak sensory block was 5.45 ± 0.50 min, duration of onset to motor block was 7.05 ± 0.22 min, duration of sensory block was 189.80 ± 6.49 min, duration of motor block was 247.28 ± 8.42 min & mean duration of post-operative analgesia was 495.93 ± 22.43 min. Number of analgesic injections required were 3 in majority patients. Visual analogue scale score was 0 at 1 hr., 2 hr., 3 hr. & 4 hr. while at 6 hr., 8 hr., 10 hr., 12 hr., 18 hr. & 24 hrs. median VAS was < 5. Bradycardia was noted in one patient and hypotension occurred in two patients, which were managed effectively. Overall incidence of side effects was low. Conclusion: Clonidine is a good adjuvant drug and its use intrathecally as an additive to bupivacaine extends the duration of spinal anaesthesia significantly, lowering the need to administer general anaesthesia if duration of surgery is prolonged.

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