Comparing the Efficacy of Dexmedetomidine and Clonidine as Adjuncts to Intrathecal Bupivacaine for Lower Abdominal Surgeries

Abstract

Background: The preferred method for lower abdominal surgeries is administering a spinal block. Bupivacaine is a commonly used local anesthetic; however, it has a relatively short duration of action. To enhance the analgesic quality throughout the postoperative period, various enhancers have been explored. In this particular research, α²-agonists were employed [1], [2]. Objective: This study aimed to compare the effects of intrathecal dexmedetomidine and clonidine when used as adjuvants to hyperbaric bupivacaine. The comparison was focused on the onset and duration of sensory and motor blockade, analgesic duration, and the incidence of side effects. Study Design: This was a prospective randomized double-blind study. Methods: A hundred patients, classified under the American Society of Anesthesiologists Classes I and II based on their physical condition, were randomly allocated into Groups B, C, and D. Each group received a different administration: bupivacaine with normal saline, clonidine, and dexmedetomidine, respectively. [3], [4] Results: In Group B, the mean onset of sensory effects was 2.6 0.6 minutes. Comparatively, in Group C, it was 1.6 0.4 minutes, and in Group D, it was 1.4

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0.6 minutes. Additionally, the mean duration of sensory regression by two segments in Group B was 76.5 9.6 minutes, in Group C was 134.7 10.7 minutes, and in Group D was 136.4 11.7 minutes. Conclusion: The intrathecal administration of α²-agonists alongside hyperbaric bupivacaine demonstrates a quicker onset for both motor and sensory block. Furthermore, it extends the duration of analgesia.