An Observational Study To Compare Intrathecal Clonidine Vs Intrathecal Nalbuphine Along With Intrathecal Bupivacaine On Onset Duration And Postoperative Analgesia For Infraumbilical Surgeries

Abstract

Aim and Objectives:

This observational study was conducted to compare the effects of intrathecal adjuvants, Clonidine with Nalbuphine using 0.5% hyperbaric bupivacaine on onset , duration of sensory block and motor block, on hemodynamics, duration of post-operative analgesia, requirement of rescue analgesia and side effects/complications in lower abdominal surgeries.

Materials and Methods:

In this observational and comparative study of 66 patients, randomly divided into 2 groups of 33 patients each group BC & BN Group BC (CLONIDINE group) consisted of 0.5% Hyperbaric Bupivacaine 3.5 ml +0.2ml(30 mcg)clonidine = total 3.7 ml{n=33}and Group BN (Nalbuphine group)consisted of 0.5% Hyperbaric Bupivacaine 3.5 ml  +  0.2ml(2 mg)  Nalbuphine = total 3.7 ml  {n=33}. Patients aged between 18-70 years, ASA Grade I and II of either gender undergoing elective infraumbilical surgeries were included in the study. All patients were observed for onset and duration of sensory block and motor block, duration of analgesia and requirement of rescue analgesia. The hemodynamic parameters (heart rate, blood pressure, Oxygen saturation, respiratory rate) were also recorded.

Results:

Mean onset of sensory & motor block was significantly longer in BN group than BC group    (p<0.05). Mean duration of motor and sensory block was significantly longer in BC group than BN (p<0.05). Duration of postoperative analgesia was  highly significantly longer in BC group as compared to BN group (P value < 0.001). More number of rescue analgesia was required in group BN as compared to BC group and was statistically significant(p<0.05). The Intraoperative or postoperative complications in the form of nausea, vomiting, hypotension, bradycardia and urinary retention which were comparable and statistically non-significant between both the groups. The hemodynamic parameters (heart rate, blood pressure, Oxygen saturation, respiratory rate) were comparable in both the groups.

Conclusion:

We concluded that Clonidine used as an adjuvant to Intrathecal Bupivacaine prolongs duration  of sensory blockade, duration of motor blockade, post-operative analgesia and first requirement of rescue analgesia compared to intrathecal Nalbuphine