Assessment of epidural clonidine as an adjuvant to local anesthetic in lower abdominal and lower limb surgeries

Abstract

Background: Continuous epidural techniques and recent improvements in spinal catheters make the epidural and intrathecal spaces easily accessible for repetitive administration of local anesthetics to extend anesthesia. The present study was conducted to assess epidural clonidine as an adjuvant to local anesthetic in lower abdominal and lower limb surgeries.

Materials & Methods: 70 patients scheduled for elective lower abdominal, gynaecological and lower limb surgeries under epidural anesthesia of both genders were divided into 2 groups of 35 each. In group І, 0.5% bupivacaine + 0.9% normal saline, 1 ml was used and in group ІІ, 0.5% bupivacaine + Inj. Clonidine 2μg/kg (1 ml) was used. Parameters such as height, weight, mean arterial pressure, pulse rate, duration of motor blockade, duration of analgesia (in minutes), sedation score and side effects were recorded.

Results: Group I had 18 males and 17 females and group II had 20 males and 15 females. The mean weight was 54.7 kgs and 54.2 kgs, height was 165.2 cm and 164.9 cm, mean arterial pressure (mm Hg) was 86.2 and 76.1, mean pulse rate (beats/min) was 73.2 and 62.5, duration of motor blockade (in minutes) was 104.2 and 312.8, duration of analgesia (in minutes) was 140.2 and 376.4 in group I and II respectively. The difference was significant (P< 0.05). Score 1 was seen in 20 in group I, score 2 in 15 in group I and 8 in group II, score 3 in 14 in group II, score 4 in 7 in group II and score 5 in 6 in group II. The difference was significant (P< 0.05). Shivering was seen in 4 in group I, nausea in 2 in group I and vomiting 3 in group I and 1 in group II. The difference was significant (P< 0.05).

Conclusion: There was an increase in the duration of analgesia following the addition of clonidine to bupivacaine 2 ug/kg in comparison to bupivacaine alone when instilled in the epidural space.