A Comparative Study of Clonidine and Dexmedetomidine As Adjuvants To 0.5% Levobupivacaine For Epidural Anaesthesia In Patients Undergoing Lower Limb Orthopaedic Surgeries

Abstract

BACKGROUND: Epidural alpha agonists prolong the duration of action of local anesthetics and reduce the required dose. Dexmedetomidine is an α-2 receptor agonists and its α2/α1 selectivity is 8 times higher than that of clonidine.

AIMS: In this study, we aimed to investigate the effect of adding dexmedetomidine to epidural levobupivacaine on the onset time and duration of motor and sensory blocks.

METHODS: Patients were randomly assigned into two groups. Group I- 0.5% levobupivacaine (15ml) with clonidine (1mcg/kg made into 1ml) with a total volume of 16ml and Group II- 0.5% levobupivacaine (15ml) with dexmedetomidine (1mcg/kg made into 1ml) with a total volume of 16ml. Sensory and motor block onset time, block reaching time to T10 dermatome, the most elevated dermatome level, two dermatome regression time, sensory and motor block complete regression.

RESULTS: Sensory and motor block onset times were shorter in Group II than in Group I. The regression of the sensory and motor block were longer in Group II than Group I. The two dermatome regression time was longer in Group II than Group I. There were no statistically significant differences between groups in blood pressure and heart rate. There was no statistically significant difference between groups when adverse events were compared.

CONCLUSION: We conclude that epidural dexmedetomidine addition to levobupivacaine significantly prolongs sensory and motor block and post-operative analgesia as compared to Clonidine.