| Abstrakt: |
Various adjuvants are being used with local anaesthetics for prolongation of intraoperativeand post operative analgesia. Clonidine and dexmedetomidine, alpha 2 adrenergic agonists are being used as non opioid neuraxial adjuvants. This study aims to assess the quality of subarachnoid block using intrathecal adjuvants fentanyl, clonidine and dexmedetomidine with hyperbaric bupivacaine in infraumbilical surgeries. Methods:After obtaining ethical clearance and informed consent patients of ASA 1 and 2between 18 to 60yrs of either sex were randomly allocated into 3 groups (30 patients each).Patients with pregnancy, hypertension, bleeding diathesis and psychiatric illness wereexcluded from the study. Group F received 15µg fentanyl, group C received 30µg clonidine and group D received 5µg dexmedetomidine with 12.5mg hyperbaric bupivacaine each. The onset time to reach peak sensory and motor level, the regression time of sensory and motor blockade, hemodynamic changes and side effects were recorded. Results: The mean time of duration of sensory blockade was 254±21min in Group D, 223±25min in Group C, 204±27min in Group F. The regression time of motor block to reach Modified Bromage Zero was 225.52±18.82min, 198±21min, 177±27min in Group D, C and F respectively. The patients in group D had significantly prolonged sensory and motor blockade and less and delayed requirement of rescue analgesic than in group C and F. Conclusion: Intrathecal dexmedetomidine as adjuvant is better than clonidine and fentanyl as it prolongs motor and sensory block and reduced demand of rescue analgesic. [ABSTRACT FROM AUTHOR] |
