A Comparative Study between Intrathecal Clonidine and Neostigmine with Intrathecal Bupivacaine for lower abdominal surgeries

Abstract

Background: Limited duration of time has been one of the main drawback of spinal anesthesia.To avoid this adjuvants have been added to the local anesthetic agent and has proven benefits when used intrathecally. Aims and Objectives: To compare the effect of intrathecal clonidine 75 µg or neostigmine 50 µg added to intrathecal hyperbaric bupivacaine, with respect to sensory characteristics, motor characteristics, haemodynamic stability and side effects. Materials and Methods: Our prospective study included 60 patients who were admitted for lowe abdominal surgeries. The patients were randomly divided into 2 groups, with 30 in each group. Group A patients received neostigmine 50 µg with 2.5 ml of intrathecal 0.5% hyperbaric bupivacaine and group B patients received intrathecal clonidine 75 µg and 2.5 ml of intrathecal 0.5% hyperbaric bupivacaine. The parameters for comparison of 2 groups included sensory characteristics, motor characteristics, haemodynamic stability and side effects.
Results: In Group B patients, there was a significantly enhanced onset of sensory and motor block and well maintained haemodynamics. Group A patients had prolonged analgesia. Perioperatively no serious adverse effects were noted in both the groups. Conclusion: Intrathecal clonidine with hyperbaric bupivacaine produces prolonged postoperative analgesia and intrathecal neostigmine with bupivacaine produces a good sensory and motor blockade
for lower abdominal surgeries.