Comparison of Intrathecal Levobupivacaine versus Bupivacaine with Clonidine as Adjuvant

Introduction: Spinal anesthesia is an acceptable method to provide anesthesia for lower abdominal surgeries. Anesthesiologists are always in search of such combinations of local anesthetics with adjuvants, for spinal anesthesia, which can provide good relaxation and prolonged analgesia without any hemodynamic disturbances. Purpose: To re-evaluate the dogma associated with clonidine when added as adjuvant to bupivacaine causing hemodynamic instability and to compare this with clonidine as adjuvant to levobupivacaine. Materials and Methods: In this study, we compared intrathecal clonidine as an adjuvant to levobupivacaine with bupivacaine. 80 patients of American Society of Anesthesiologists 1 and 2 of either sex were divided into two groups of 40 each. In Group 1 - We used bupivacaine 0.5% 15 mg + 30 mcg clonidine. In Group 2 - We used levobupivacaine 0.5% 15 mg + 30 mcg clonidine. Sensory and motor blockade in terms of onset and duration, hemodynamic parameters, i. e. mean arterial pressure and heart rate were recorded and compared. Results: Onset of sensory and motor blockade is significantly prolonged in Group 2. Time taken to reach sensory blockade up to T10 and motor blockade bromage Grade 3 was significantly increased in Group 2. Regression time was significantly prolonged in Group 2. Group 1 patients had hypotension and tachycardia ranging from 10 to 20% compared to Group 2. Conclusion: We compared intrathecal clonidine with bupivacaine and levobupivacaine. Patients, who received intrathecal levobupivacaine with clonidine had better and prolonged state than the patients with intrathecal bupivacaine and clonidine. Hemodynamic changes were minimum in levobupivacaine group.