A comparative study between intrathecal isobaric ropivacaine 0.75% (15 mg) plus dexmedetomidine (10 mcg) and isobaric ropivacaine 0.75% (15 mg) plus clonidine (30 mcg) for elective lower abdominal and lower limb surgeries

Abstract

Background: Pain is one of the most noxious stimuli a living being perceives; the most painful moments are the surgical procedure. The present study compared intrathecal isobaric ropivacaine 0.75% (15 mg) plus dexmedetomidine (10 mcg) and isobaric ropivacaine 0.75% (15 mg) plus clonidine (30 mcg) for elective lower abdominal and lower limb surgeries. Materials and Methods: 100 consenting patients undergoing lower abdominal and lower limb surgeries under intrathecal anesthesia were randomized into the following groups with 50 patients in each group. Group C patients received isobaric ropivacaine 0.75% 15 mg + 30 mcg clonidine. Group D patients received isobaric ropivacaine 0.75% 15 mg + 10 mcg dexmedetomidine. Results: The mean duration of surgery is 101.04 ± 24.18 mins in Group C and 107.42 ± 27.50 mins in Group D. In Group C, the mean time to onset of sensory analgesia till T 10 was 6.1 minutes and in Group D was 3.68 minutes. In Group C, 30 patients (60%) had a maximum sensory level of T6, 8 patients (16%) had a level of T8, and 12 patients (24%) had a level of T10. In Group D, 2 (4%) had a maximum sensory level of T5, 32 patients (64%) had a level of T6, 6 patients (12%) had a level of T8, 10 patients (20%) had a level of T10. There was no statistically significant difference between the groups (p value > 0.05) in the maximum sensory level achieved. In Group C the mean time taken from onset of sensory blockade to regression to T12 was 151.7 minutes and in Group D was 199.7 minutes. In Group C the mean time to first postoperative analgesic requirement was 267.6 minutes and in Group D was 356.9 minutes. In Group C, the mean time taken to achieve complete motor blockade was 12.66 minutes and in Group D was 11.14 minutes. Conclusion: Dexmedetomidine added to ropivacaine provided earlier sensory blockade, prolonged duration of sensory and motor blockade for patients under intrathecal anesthesia for lower limb surgeries.