A comparative clinical study of intrathecal fentanyl and clonidine with hyperbaric bupivacaine in lower segment caesarean section

Abstract

To compare between clonidine and fentanyl as adjuvants with intrathecal bupivacaine in LSCS patients to know the: 1) Starting time and total time of sensory block; 2) Starting time and total time of motor block; 3) Total time of postoperative analgesia. In a prospective, randomized study, 120 patients who are to undergo caesarean section between 18 and 30 years of age and of ASA grade I or II were randomly distributed into three groups. Patients were given intrathecally 2 ml of hyperbaric bupivacaine 0.5% (control group) or bupivacaine combined with 45mg of clonidine (clonidine group) or with 25mg of fentanyl (fentanyl group). Study of starting time and total time of sensory and motor blockade, level of sedation, total time of perioperative analgesia, maternal hemodynamic and fetal parameters were compared. Time to two segment regression was increased in fentanyl group and clonidine group than in control group. Total time of analgesia was significantly more in fentanyl group and clonidine group than in control group. There was increased incidence of side-effects in clonidine group than other two groups.Postoperative analgesia was increased by addition of 25mg fentanyl and 45mg clonidine to bupivacaine, with more side effects like hypotension, bradycardia and sedation in clonidine group.