A Comparative Evaluation of Dexmedetomidine and Clonidine as an Adjunct with Intrathecal Inj. Levobupivacaine in Spinal Anaesthesia

Background: Clonidine and Dexmedetomidine are alpha 2 adrenergic agonists when used intrathecally with local anesthetics, they are known to potentiate the action of local anesthetics as well as have analgesic properties. Aim: To find better adjuvant in regional anesthesia comparing efficacy and clinical profile of alpha 2 adrenergic agonists Clonidine and Dexmedetomidine with special emphasis on the following parameters 1. Hemodynamic stability and sedative property 2. Onset and duration of sensory and motor block 3. Ability to provide smooth intra operative and post operative analgesia. Methods: 50 patients of ASA grade I and II, scheduled for lower abdominal and lower limb surgery at our institute satisfying inclusion criteria were selected and divided randomly into two groups C and D. Hemodynamic parameters, onset and duration of sensory block and motor block, duration of spinal anesthesia and sedation scores recorded. Results: Sensory and motor block times were significantly longer in group D than Group C. The mean duration of sensory block was 205.2 (+/- 25.87) min. in group C and 261.6 (+/- 32.71) min. in group D and mean recovery time of motor block was 251.4 (+/- 40.44) min. in group C and 322.2 (+/- 24.60) in group D. Patient of group D had significantly less and delayed requirement of rescue analgesic i.e. mean duration of spinal anesthesia is 378.6 (+/- 75.49) min. in group C and 492 (+/- 49.99) min. in group D. Conclusion: Intrathecal Dexmedetomidine with isobaric Levobupivacaine significantly prolongs sensory and motor block and post operative analgesia as compared to Clonidine.