COMPARATIVE STUDY OF EFFICACY AND SAFETY OF INTRATHECAL DEXMEDETOMIDINE VERSUS INTRATHECAL CLONIDINE AS AN ADJUVANT WITH 0.5% HYPERBARIC BUPIVACAINE TOTAL ABDOMINAL HYSTERECTOMY PROCEDURES

INTRODUCTION: Newer alpha-2 agonistic agents have opened a new chapter in the history of postoperative analgesia. MATERIAL AND METHODS: Ninety adult patients of ASA grade I-II were randomly divided into three groups of thirty each. Groups A, B, C received hyperbaric bupivacaine 0.5% 3.4 ml intrathecally with normal saline 0.5 ml, with dexmedetomidine 15 mu g, and with clonidine 75 mu g respectively. Hemodynamic data, degree of motor block (modified bromage scale), time to reach sensory block to L1 level, time for two segment regression of sensory block and time to reach modified bromage 0, total duration of analgesia was assessed. RESULT AND CONCLUSION: Onset time of sensory and motor block was shorter in group B and group C compared to group A. Two segment regression time of sensory block was significantly higher in group B (122.60+17.44min) and group C (87.73+10.37min) as compared to group A(63.73+8.70min). Regression time to reach Modified bromage 0 was significantly high in group B (235.10+26.64min) and group C (226.70+45.85min) as compared to group A (174.53+22.03min). Total duration of analgesia was significantly prolonged in group B (346.26+41.63min) and group C (302.85+38.45min) as compared to Group A (162.80+39.55min). Heart rate and mean arterial pressure remained at lower level in group B and group C as compared to group A but that was not statistical significant. It can be 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.