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Article type :

Original Article

Author :

Jatin Babubhai Patel, Aiman Monaf, Tejash H Sharma, Arpit Sanjaykumar Shah, Sara Mary Thomas

Volume :

12

Issue :

2

Abstract :

Background and Aims: Adjuvants are commonly added to local anaesthetics in subarachnoid block to prolong both aesthetic and analgesic duration. This study aimed to compare the effects of two different doses of intrathecal clonidine (30 µg and 50 µg) as adjuvants to hyperbaric ropivacaine in lower limb orthopaedic surgeries. The outcomes evaluated included hemodynamic changes, sedation levels, duration of analgesia, and sensory and motor blockade characteristics. Materials and Methods: Ninety patients were randomly assigned into two groups. Group RC30 received 0.75% hyperbaric ropivacaine 3 mL combined with clonidine 30 µg, diluted with normal saline to a total volume of 3.5 mL. Group RC50 received 0.75% hyperbaric ropivacaine 3 mL combined with clonidine 50 µg, diluted with normal saline to achieve a total volume of 3.5 mL. The study compared the duration of analgesia, sensory and motor blockade, side effects, complications, and hemodynamic changes between the two groups. Results: Group RC30 took a longer time to reach the highest spinal level (12.2 ± 1.26 min) compared to Group RC50 (11.8 ± 1.2 min, P = 0.003). Time to two segment regression was significantly longer in Group RC50 (148.10 ± 8.18 min) than in Group RC30 (102.5 ± 6.8 min, P). Sensory and motor blockade durations were also extended in Group RC50 (263.3 ± 9.2 min and 359.2 ± 18.1 min, respectively) compared to Group RC30 (215.78 ± 7.7 min and 300.27 ± 10.6 min, respectively, P). The duration of analgesia were significantly longer in Group RC50 (300.5 ± 18.2 min and 451.70 ± 18.2 min, respectively) compared to Group RC30 (289.9 ± 11.9 min and 363.8 ± 11.2 min, P). However, Group RC50 demonstrated a higher incidence of bradycardia and hypotension, which were effectively managed with standard therapeutic interventions. Conclusion: Intrathecal clonidine at a dose of 50 µg provides superior analgesic effects compared to 30 µg but is associated with an increased risk of bradycardia and hypotension. Careful monitoring and timely interventions are crucial when using higher doses.