Effects of Intramuscular Dexmedetomidine Versus Clonidine on the Duration of Subarachnoid Block and Analgesia for Lower Limb Orthopedic Surgeries

  • Snehalatha Bhashyam Rangaraya Medical College, Kakinada, Andhra Pradesh, India
  • G Prasanna Kumar Rangaraya Medical College, Kakinada, Andhra Pradesh, India
  • T Prem Sagar Rangaraya Medical College, Kakinada, Andhra Pradesh, India
  • S Gayathri Rangaraya Medical College, Kakinada, Andhra Pradesh, India
Keywords: Clonidine, Dexmedetomidine, Intramuscular, Post-operative analgesia, Premedication

Abstract

Background: Alpha-2adrenergic agonists, when used simultaneously as systemic adjuvants to local anesthetics show synergistic action and improve the quality of spinal anesthesia and prolong the post-operative analgesia. We aimed to study the effects of intramuscular dexmedetomidine versus clonidine on the duration of bupivacaine sub-arachnoid block, post-operative analgesia, and sedation in patients undergoing lower limb orthopedic surgeries.
Materials and Methods: The study design was a prospective, randomized, and double-blind study. Eighty adult consented patients of ASA I or II, scheduled for orthopedic lower limb surgeries under spinal block were randomized to two groups of 40 patients per group. Group D received IM dexmedetomidine 1 μgkg−1, Group C received IM clonidine 2 μgkg−1, and 30 min before the bupivacaine subarachnoid block. The time of onset of sensory and motor block, the time required for complete sensory and motor recovery, time of the first request of rescue analgesia, and sedation levels were compared between the groups. Collected data were analyzed using the student “t” test, Chi-square test/Fisher exact test, and P < 0.05 was considered statistically significant.
Results: The mean onset time of sensory and motor block was reduced, the mean time required for complete sensory recovery was increased and the time of the first request of rescue analgesia was prolonged in the dexmedetomidine group compared to clonidine group with a significant P < 0.05. Ramsay sedation score was higher in the dexmedetomidine group compared to clonidine group (P = 0.003)
Conclusion: Premedication with a single dose of intramuscular dexmedetomidine before bupivacaine spinal anesthesia acts as an effective adjuvant and potentiates the quality of block and prolongs post-operative analgesia more than intramuscular clonidine

Author Biographies

Snehalatha Bhashyam, Rangaraya Medical College, Kakinada, Andhra Pradesh, India

Assistant Professor, Department of Anesthesiology and Critical Care,

G Prasanna Kumar, Rangaraya Medical College, Kakinada, Andhra Pradesh, India

Associate Professor, Department of Anesthesiology and Critical Care, 

T Prem Sagar, Rangaraya Medical College, Kakinada, Andhra Pradesh, India

Professor, Department of Anesthesiology and Critical Care

S Gayathri, Rangaraya Medical College, Kakinada, Andhra Pradesh, India

Post Graduate, Department of Anesthesiology and Critical Care

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How to cite this article: Bhashyam S, Kumar GP, Sagar TP, Gayathri S. Effects of Intramuscular Dexmedetomidine Versus Clonidine on
the Duration of Subarachnoid Block and Analgesia for Lower Limb Orthopedic Surgeries. Int J Sci Stud 2020;8(4):142-148.
Source of Support: Nil, Conflicts of Interest: None declared.
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Published
2021-09-29