A comparative study of different adjuncts to enhance the effects of intrathecal bupivacaine

Debajyoti Sur; Archana Agarwal; Ajay Kumar Chaudhary; Jaishri Bogra; Prithvi Kumar Singh; Rajni Gupta; Vinod Kumar Bhatia

doi:10.18203/2320-6012.ijrms20171840

Authors

Debajyoti Sur Department of Anaesthesiology, Murshidabad Medical College and Hospital, West Bengal, India
Archana Agarwal Department of Anaesthesiology, Hind Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
Ajay Kumar Chaudhary Department of Anaesthesiology, King George’s Medical University, Lucknow, Uttar Pradesh, India
Jaishri Bogra Department of Anaesthesiology, Hind Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
Prithvi Kumar Singh Department of Anaesthesiology, Murshidabad Medical College and Hospital, West Bengal, India
Rajni Gupta Department of Anaesthesiology, Murshidabad Medical College and Hospital, West Bengal, India
Vinod Kumar Bhatia Department of Anaesthesiology, Murshidabad Medical College and Hospital, West Bengal, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20171840

Keywords:

Bupivacaine, Clonidine, Dexmedetomidine, Intrathecal, Magnesium

Abstract

Background: Spinal anaesthesia is the commonly used technique for lower abdominal surgeries. Adjuvants to bupivacaine have been used to provide good quality of perioperative and postoperative analgesia. The aim of the study was to evaluate the effects of subarachnoid administration of bupivacaine with clonidine, magnesium, dexmedetomidine and saline group.

Methods: The prospective, comparative single blind study included 120 patients in American society of anaesthesiologist (ASA) grade I and II, scheduled for lower abdominal surgeries were allocated in four groups. Each group included 15 mg bupivacaine with various adjuvants (30 µg clonidine, 50 mg magnesium sulphate and 3µg dexmedetomidine) were compared with saline group (group S).

Results: Time of onset was earlier in groups D and C but delayed in group M. The total power regains (B0) in group D (250.8±18.87), group M (235.23±24.66) and group C (242.70±25.98) were significantly delayed (p<0.05) as compare with group S (180.07±18.53). Demand of analgesia was significantly earlier in group S as compared with groups C, M and D. Similarly, the time of two segment regression was significantly earlier in group S as compared with groups C, M and D (p<0.001). Patients were hemodynamically stable in groups D, C and M as compared to Group S.

Conclusions: Dexmedetomidine and clonidine were equally effective and better as compared to magnesium as an adjunct to intrathecal bupivacaine.

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