Abstract:

Objective : To compare the efficacy ,onset of sensory and motor block and the level of sensory and motor block achieved in the groups.of Bupivacaine+ normal saline,Bupivacaine heavy + fentanyl & Bupivacaine heavy + clonidine for subarachnoid block in lower limb orthopaedics surgeries.Methods this study was conducted in a randomized fashion on 90 ASA grade 1 &ll patients in the age group of 20-50 years posted for surgery .The subjects were randomly allocated to 3 groups of 30 each:Group l : 3 ml of 0.5% heavy bupivacaine + 1 ml normal saline intrathecally.Group ll : 3 ml of 0.5% heavy bupivacaine + 1 ml fentanyl (50μg) intrathecally.Group lll :3 ml of 0.5% heavy bupivacaine + 1 ml clonidine (150 μg)intrathecally.All patients were monitored intraoperatively for vital parameters. Onset and recovery of sensory and motor block noted. All vital parameters were noted at regular interval and patients were observed for any side effects intraoperatively and postoperatively.For postoperative pain measurement VAS score was taken and the time taken for regression of 2 sensory segments and time taken for regression of sensory block below L1 level was noted.Results: There was no statistical difference was observed in the time of onset of sensory and motor block. In comparison to the other two group, the duration of sensory and motor block was significantly more in group lll where clonidine was added to hyperbaric bupivacaine intrathecally. There was significant prolongation of effective ananlgesia in group lll i.e. the requirement of rescue analgesic was delayed when compared to group ll& group l. There was significant fall in BP in group lll. There was a reduced incidence of nausea and vomiting in group lll but mild sedation and low incidence of bradycardia was found.The VAS score for postoperative pain score was significantly less in group lll in comparison to the other 2 groups. Conclusion To conclude, the combination of group lll drugs i.e. 0.5% hyperbaric bupivacaine +150μg clonidine intrathecally is found better as it provides better postoperative analgesia as compared to group l & group ll in the present study.

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