Comparison of Intrathecal Clonidine and Dexmedetomidine as Adjuvants to Hyperbaric Bupivacaine for Lower Limb Surgery

Introduction Effective pain management in lower limb surgeries is crucial for patient care. Spinal anesthesia, commonly used for its rapid onset, can be enhanced by adjuvants like clonidine and dexmedetomidine. These α2-adrenergic agonists prolong sensory and motor blockade, improving postoperative analgesia. Clonidine, inhibits norepinephrine release, while dexmedetomidine, more selective, offers profound analgesia without significant sedation. Methods This prospective, randomized, double-blind study compared intrathecal clonidine and dexmedetomidine as adjuvants to hyperbaric bupivacaine in lower limb surgery. Adult participants undergoing elective procedures were included, and randomization was computer-generated with concealed allocation. Primary outcome was sensory blockade duration; secondary outcomes included motor blockade duration, postoperative analgesia, hemodynamic parameters, and adverse effects. Data collection, statistical analysis, and ethical considerations were conducted rigorously, adhering to ethical guidelines and obtaining informed consent from participants. Results Dexmedetomidine significantly prolongs sensory blockade compared to Clonidine, with median regression times of 120 vs. 90 minutes. Dexmedetomidine significantly extends the duration of motor blockade compared to Clonidine, with median regression times of 210 minutes versus 150 minutes. Group B (Dexmedetomidine) required significantly less postoperative analgesia within the first 24 hours, with an average consumption of 15 mg morphine equivalent, compared to 20 mg in Group A (Clonidine). Both drugs maintained stable hemodynamic conditions during and after surgery, with no significant differences observed. Conclusion Our study clearly demonstrates that Dexmedetomidine serves as a superior adjuvant to Clonidine when combined with hyperbaric Bupivacaine for spinal Anesthesia in lower limb surgeries.