Published: 2017-01-03

Comparative analysis of injection clonidine and injection dexmedetomidine added to injection bupivacaine for spinal anaesthesia in lower abdominal surgeries

Seema Partani, Alka Kewalramnani Chhabra, Sangeeta Goyal, Nagendra Prasad Sharma, Saurabh Bhateja, Shashank Gupta


Background:Efficacy of sub-arachnoid block can be improved by addition of various adjuvants to local anesthetics. Intrathecal administration of clonidine or dexmedetomidine has improved the quality of spinal anesthesia in terms of longer duration of post-operative analgesia with comparatively lesser side effects. In present study we compared the onset and duration of motor and sensory block, hemodynamic effects, post-operative analgesia and adverse effects of clonidine and dexmedetomidine used intrathecally with bupivacaine.

Methods: Present study was conducted in 150 patients (ASA class I and II) undergoing lower abdominal surgeries. Patients were randomly divided into three group’s viz. B, C and D. Group B received bupivacaine (12.5 mg), group C received clonidine (30 µg) with bupivacaine and group D received dexmedetomidine (5 µg) with bupivacaine. Volume of administered drug was set at 3ml in all the groups. The onset time to reach peak sensory and motor block level, regression time to sensory and motor block, hemodynamic changes and side effects if any were assessed and recorded.

Results: In our study we observed that there was no significant difference in patient demography and duration of surgical procedure. The time to onset of sensory blockage was similar in all the three groups but time to onset of motor block was shorter in group C and D compared to group B. Total duration of sensory and motor block was significantly higher in group D compared to group C and B. The duration of sensory block in group D was 139.58+14.49, in group C it was 122.46+18.55 and in group B it was 100+13.43 minutes. The duration of motor block in group D was 250.40+27.33, in group C it was 229.28+23.68 and in group B it was 175.64+17.41 minutes.

Conclusions: It was concluded that though both clonidine and dexmedetomidine prolonged duration of sensory and motor block of Bupivacaine, Dexmedetomidine is better in terms of longer duration of action.



Bupivacaine, Clonidine, Dexmedetomidine, Spinal anesthesia, α-2 adrenoceptor agonist

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Sarma J, Narayana PS, Ganapathi P, Shivakumar MC. A comparative study of intrathecal clonidine and dexmedetomidine on characteristics of Bupivacaine spinal block for lower limb surgeries. 2015;9(2):195-207.

Liu S, Carpenter RL, Neal JM. Epidural anesthesia and analgesia. Their role in post-operative outcome anesthesiology. 1995;82:1474.

Wu CL, Fleisher LA. outcomes research in regional anesthesia and analgesia. Anesth Analg. 2009;91:1232.

Corning JL. Spinal anesthesia and local medication of the cord. N Y State J Med. 1885;42:483-5

Corning JL. A further contribution on local medication of the spinal cord with cases. New York. Medical Record. 1888:291-3.

Gabriel JS, Gordin V. Alpha 2 agonist in regional anesthesia and analgesia. Curr Opin Anesthesiol. 2001;14:751-3.

Kim JE, Kim NY, Lee HS, Kil HK. Effects of Intrathecal dexmedetomidine on Low-Dose bupivacaiane spinal anesthesia in elderly patients Undergoing Transurethral prostatectomy. Biol Pharm Bull. 2013;36(6):959-65.

Suthar O, Sethi P, Sharma UD. Comparison of dexmedetomidine, and clonidine,as blind controlled an adjuvants to Intrathecal bupivacaine in lower limb surgery: a randomized , double trial. Anaesth Pain and Intensive Care. 2015;18(2):149-54.

Kanazi GE, Aouad MT, Jabbour-Khoury SI, Al Jazzar MD, Alameddine MM, Al-Yaman R, Bulbul M, Baraka AS. Effect of low-dose dexmedetomidine or clonidine on the characteristics of bupivacaine spinal block. Acta Anaesthesiol Scand. 2006;50(2):222-7.

Al Ghanem SM, Massad IM, Al Mustafa MM, Al-Zaben KR, Qudaisat IY, Qatawneh AM, et al. Effect of adding dexmeditomidine versus fentanyl to intrathecal bupivacaine on spinal block characteristics in gynecological procedures: a double blind controlled study. Am J Appl Sci. 2009;6:882-7.

Al-Mustafa MM, Abu-Halaweh SA, Aloweidi AS, Murshidi MM, Ammari BA, Awwad ZM et al. Effect of dexmeditomidine added to spinal bupivacaine for urological procedures. Saudi Med J. 2009;30:365-7.

Jain G, Chauhan D, Chauhan G, Upadhyaya RM. Comparison between dexmedetomidine and clonidine as an adjuvant to spinal anesthesia in abdominal hysterectomy. IJSR.

Singh R, Shukla A. Randomized controlled study to compare the effect of intrathecal clonidine and dexmedetomidine on sensory analgesia and motor block of hyperbaric bupivacaine. Ind J Fund Appl Life Sci. 2012;2:24-33.

Hala EA Eid, Mohamed A Shafie, Hend Youssef. Dose-related prolongation of hyperbaric bupivacaine spinal anesthesia by dexmedetomidine. AinShamsJournalofAnesthesiology. 2011;4:83-95.

Solanki SL, Bharti N, Batra YK, Jain A, Kumar P, Nihkar SA. The analgesic effect of intrathecal dexmeditomidine or clonidine with bupivacaine in trauma patients undergoing lower limb surgery: a randomized, double blind study. Anesth intensive care.2013;41:51-6.