2020, Vol. 2, Issue 2, Part C

Objectives: The purpose of this study was to compare the clinical profile and efficacy of two alpha 2 agonists dexmedetomidine and clonidine when administered epidurally as an adjuvant to Bupivacaine in patients undergoing elective infraumbilical and lower limb surgeries.

Methods: A prospective randomized double blind controlled study was planned. 60 patients of ASA I & II physical status aged between 18-60 yrs who underwent elective infraumbilical and lower limb surgical surgery from 1^st of January 2019 to 31^st of November 2020 and satisfying all the inclusion criteria were enrolled in the study and were randomly allocated into two groups.

Group A (n=30) = patients received 0.5% isobaric bupivacaine 15 ml with dexmedetomidine 1µg/kg.

Group B (n=30) = patients received 0.5% isobaric bupivacaine 15ml with clonidine 2µg/kg.

Results: Addition of dexmedetomidine to bupivacaine as an adjuvant resulted in an earlier onset of sensory analgesia at T10 as compared to the addition of clonidine. Dexmedetomidine not only provided a higher dermatomal spread but also helped in achieving the maximum sensory anaesthetic level in a shorter period compared to clonidine Modified Bromage scale 3 was achieved earlier in patients who were administered dexmedetomidine as an adjuvant. All these initial block characteristics turned out to be statistically significant values on comparison. Dexmedetomidine is a popular sedative agent nowadays and similar findings were observed in our study as well. Mean sedation scores were significantly higher in Dexmedetomidine group compared to Clonidine group. Dexmedetomidine provided a smooth and prolonged post-operative analgesia as compared to clonidine. Time to two segmental dermatomal regression as well as return of motor power to Bromage 1 was significantly prolonged in dexmedetomidine group. As a result patients in clonidine group required rescue analgesia earlier than dexmedetomidine group.

Conclusion: Dexmedetomidine is a better adjuvant than clonidine in epidural anaesthesia because of better sedation, anxiolysis, superior intraoperative and postoperative analgesia and stable cardio-respiratory parameters.