Efficacy of epidural clonidine versus dexmedetomidine in postoperative analgesia with bupivacaine in total abdominal hysterectomy

Introduction: This study compares the efficacy of clonidine and dexmedetomidine as adjuvants to epidural bupivacaine for postoperative analgesia in patients undergoing total abdominal hysterectomy. Methods: Sixty female patients scheduled for elective surgery were randomly assigned to two groups. Group C received clonidine (1 mcg/kg) with 0.125% bupivacaine, and Group D received dexmedetomidine (0.5 mcg/kg) with 0.125% bupivacaine epidurally. Postoperative pain was assessed using the Visual Analogue Scale (VAS), and the need for rescue analgesia, hemodynamic parameters, sedation levels, and adverse effects were recorded. Results: Both groups were comparable in demographics. Group D showed significantly lower VAS scores between the 5th and 8th postoperative hours (p<0.001), indicating superior analgesia. Time to first rescue analgesia was longer in Group D. Hemodynamic stability was better maintained with dexmedetomidine, with fewer instances of hypotension requiring vasopressors. Conclusion: Dexmedetomidine as an adjuvant to epidural bupivacaine provides better postoperative an algesia and hemodynamic stability compared to clonidine. It appears to be a more effective choice for prolonged pain relief after total abdominal hysterectomy.