Evaluation of Nalbuphine with that of Clonidine as an Adjuvant to IntraThecal 0.5% Hyperbaric Bupivacaine

Background and objectives: This study compares the clinical efficacy of nalbuphine and clonidine as adjuvants to 0.5% hyperbaric bupivacaine for Sub arachnoid block. The efficacy is compared in terms of onset of block, duration of block, and quality of sensory and motor blockade, as well as other associated side effects. Methodology: Sixty adult patients ranging between 18 to 65 years and having ASA physical status I or II and were scheduled for lower abdominal surgeries from January to December 2020, were enrolled in this randomized type of study. To ensure proper study without any bias, computer-generated randomisation sequence was used to allocate participants evenly into two groups (n=30 each). Group N received an intrathecal dose comprising 2.8 ml of 0.5% hyperbaric bupivacaine combined with 0.2 ml of nalbuphine (0.4 mg), whereas Group C was administered 2.8 ml of 0.5% hyperbaric bupivacaine along with 0.2 ml of clonidine (30 µg). Sensory and motor block assessments were performed using the pinprick method and the Bromage scale, respectively. Results: Clonidine had a sensory onset of 3 (0.83) minutes compared to 4.47 (1) minutes of Nalbuphine. Onset of motor blockade of Clonidine was 5.07 (0.86) minutes compared to 6.57(1) minutes of Nalbuphine. Motor blockade in Clonidine was 294.53 (25.93) min as compared to 240.53 (23.45) min of Nalbuphine. Duration of Sensory blockade of clonidine was 323.13 (27.20) as compared to 268.93 (23.67) of Nalbuphine. Clonidine demonstrated a quicker initiation and extended duration of both sensory and motor blockade in comparison to nalbuphine. Conclusion: Both nalbuphine and clonidine effectively prolong spinal anesthesia duration when used along with bupivacaine, though clonidine shows superior efficacy in terms of onset and duration.