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Sachan P, Kumar N, Sharma J. Intrathecal clonidine with hyperbaric bupivacaine administered as a mixture and sequentially in caesarean section: A randomised controlled study. Indian J Anaesth. 2014;58(3):287-92doi: 10.4103/0019-5049.135039.
Sachan, P., Kumar, N., & Sharma, J. (2014). Intrathecal clonidine with hyperbaric bupivacaine administered as a mixture and sequentially in caesarean section: A randomised controlled study. Indian journal of anaesthesia, 58(3), 287-92. https://doi.org/10.4103/0019-5049.135039
Sachan, Prachee, et al. "Intrathecal clonidine with hyperbaric bupivacaine administered as a mixture and sequentially in caesarean section: A randomised controlled study." Indian journal of anaesthesia vol. 58,3 (2014): 287-92. doi: https://doi.org/10.4103/0019-5049.135039
Sachan P, Kumar N, Sharma J. Intrathecal clonidine with hyperbaric bupivacaine administered as a mixture and sequentially in caesarean section: A randomised controlled study. Indian J Anaesth. 2014 May;58(3):287-92. doi: 10.4103/0019-5049.135039. PMID: 25024471; PMCID: PMC4090994.
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Indian J Anaesth. 2014 May;58(3):287-92. doi: 10.4103/0019-5049.135039.

Intrathecal clonidine with hyperbaric bupivacaine administered as a mixture and sequentially in caesarean section: A randomised controlled study.

Indian journal of anaesthesia

Prachee Sachan, Nidhi Kumar, Jp Sharma

Affiliations

  1. Department of Anaeasthesia, Himalayan Institute of Medical Sciences, Doiwala, Dehradun, Uttarakhand, India.

PMID: 25024471 PMCID: PMC4090994 DOI: 10.4103/0019-5049.135039

Abstract

BACKGROUND AND AIMS: Mixing adjuvants with hyperbaric bupivacaine in a single syringe before injecting the drugs intrathecally is an age old practice. In doing so, the density of the hyperbaric solution and also of the adjuvant drugs may be altered, thus affecting the spread of drugs. Administering local anaesthetic and the adjuvants separately may minimise the effect of the changes in densities. We aimed to compare block characteristics, intraoperative haemodynamics and post-operative pain relief in parturients undergoing caesarean section (CS) after administering hyperbaric bupivacaine and clonidine intrathecally as a mixture and sequentially.

METHODS: In this single-blind prospective randomised controlled study at a tertiary care centre from 2010 to 12, 60 full-term parturients scheduled for elective CSs were divided into two groups on the basis of technique of intrathecal drug administration. Group M received mixture of clonidine (75 mcg) and hyperbaric bupivacaine 0.5% (10 mg) intrathecally, whereas Group B received clonidine (75 mcg) followed by hyperbaric bupivacaine 0.5% (10 mg) through separate syringes. Observational descriptive statistics, analysis of variance test, Wilcoxon test and Chi-square test were used as applicable.

RESULTS: Duration of analgesia was significantly longer in Group B (474.33 ± 20.79 min) in which the drug was given sequentially than in Group M (337 ± 18.22 min). Furthermore, the time to achieve highest sensory block and complete motor block was significantly less in Group B without any major haemodynamic instability and neonatal outcome.

CONCLUSIONS: When clonidine and hyperbaric bupivacaine were administered in a sequential manner, block characteristics improved significantly compared to the administration of the mixture of the two drugs.

Keywords: Adjuvants; caesarean section; clonidine; hyperbaric bupivacaine; spinal anaesthesia

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