A Comparative Study on Efficacy of Intrathecal Clonidine with Bupivacaine and Dexmedetomidine with Bupivacaine for Surgeries below Umbilicus

Background: Pain management is crucial in healthcare. Neuraxial anaesthesia, particularly intrathecal administration of local anaesthetics, is effective for intraoperative and postoperative pain relief. Both clonidine and dexmedetomidine, alpha-2 adrenergic agonists, show promise in prolonging sensory and motor blockade and reducing supplemental analgesia. The aim of this study is to provide evidence to guide clinical practice and improve anaesthesia for surgeries below the umbilicus. Methods: 120 patients belonging to ASA I and II, posted for infraumbilical surgeries were divided into 3 groups of 40 each and received intrathecal drug as follows: Group-B: 0.5% Bupivacaine 15mg (3ml) + 0.5 ml Normal saline (NS) (Total volume 3.5ml). Group-C: 0.5% Bupivacaine 15mg (3ml) + 50 µg Clonidine (0.5ml) (150 µg [1ml] diluted to 1.5ml with NS and 0.5 ml was given). Group-D: 0.5% Bupivacaine 15mg (3ml) + 5 µg Dexmedetomidine (0.5ml) (50 µg [0.5ml] diluted to 5ml with NS and 0.5ml was given) Total Volume 3.5ml). Onset and duration of sensory and motor block, hemodynamic parameters, duration of analgesia and complications (if any) were observed. Results: The time of onset of sensory and motor block was fastest in group C followed by group D and then group B. The mean duration of sensory, motor blockade and duration of analgesia was longest in group D followed by group C and group B. (p < 0.05). Conclusions: The present study showed that supplementation of Bupivacaine in spinal block with low dose Dexmedetomidine produced a statistically significant longer duration of sensory and motor block and prolonged duration of analgesia when compared to Clonidine.