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Research Paper | Anaesthesiology | India | Volume 12 Issue 1, January 2023
Paediatric Spinal Anaesthesia - With and Without Clonidine as adjuvant
Flory Judy Britto | Prasad K Kulkarni [2]
Abstract: Introduction: This study was done to compare the efficacy and safety of spinal anaesthesia, duration and quality of post operative analgesia using intrathecal bupivacaine alone and bupivacaine plus clonidine. Objective: A prospective randomised single blinded study was carried out in 60 ASA - 1 paediatrics patients between the age group of 1year to 18 years undergoing surgeries below T8 dermatome up to 2 hrs duration. Patients were randomly allocated in two groups. Method: Group - A received 0.5% bupivacaine heavy (0.4mg/kg for 5 - 15kg or 0.3mg/kg for >15 kg) and Group - B received bupivacaine 0.5%heavy (0.4mg/kg for 5 - 15kg or 0.3mg/kg for >15kg) and preservative free clonidine (1 mcg/kg), comprising 30 patients each. Time of onset of sensory block, maximum level of sensory block, duration of sensory block, duration of post - op analgesia was observed. Results: Mean duration of sensory blockade (147.68?7.28 vs 260.33?9.03min; P<0.001) and motor blockade (132.5?10.06 vs 233.33?8.58min; P < 0.001) and duration of analgesia (172?10.61 vs 324.50?26.55min; P < 0.001) were significantly prolonged in the clonidine group. In the control group, most patients needed three analgesic doses over 24hr while in the clonidine group, the majority needed two doses. Adverse effects were infrequent in both groups. Conclusions: Clonidine as an adjuvant to 0.5% bupivacaine heavy significantly prolonged the duration of analgesia with improved quality of anaesthesia while maintaining safety. We recommend the routine use of clonidine 1 ?g/kg dose as an adjuvant to 0.5% bupivacaine in paediatric Spinal Anaesthesia.
Keywords: Paediatric anaesthesia, clonidine. Bupivacaine, spinal anaesthesia, analgesia, pre - medication, adjuvant
Edition: Volume 12 Issue 1, January 2023,
Pages: 102 - 104