Title: Effect of Dexmeditomidine and Clonidine as Spinal Adjuvant in TURP – A Comparative Study
Authors: Satish Logidasan, Kanimozhi Rathinasamy, Arulraj Panchatcharam
DOI: https://dx.doi.org/10.18535/jmscr/v5i8.143
Abstract
Background: The standard anaesthetic technique for TURP (Transurethral Resection of Prostate) is subarachnoid block. Bupivacaine is the local anaesthetic drug used to achieve the subarachnoid block. Adjuvants are used to enhance analgesia, to lower the bupivacaine dosage and to reduce the dose dependent side effects. Effects of Clonidine and Dexmedetomidine on subarachnoid block in TURP are compared in this study.
Aim: Aim of this study is to compare Dexmedetomidine and Clonidine as spinal adjuvant with Bupivacaine in TURP surgeries.
Settings and Design: This is a randomized double blinded study conducted in 60 patients of ASA I and II undergoing elective TURP surgeries. Patients were allocated in three groups. Group A (Bupivacaine + sterile normal saline as placibo) Group B (Bupivacaine + Clonindine 30µg) Group C (Bupivacaine + Dexmedetomidine 5µg).
Materials and Methods: After getting the ethical committee approval the study was conducted in 60 patients undergoing elective TURP surgeries. It was a double blinded study in which patients were randomly allocated into three groups by using the computer based randomization Group A- Inj. 0.5% Bupivacaine 2.0 cc + Normal saline 0.5cc = 2.5cc ,Group B (clonidine)Inj. 0.5% Bupivacaine 2.0 cc + Inj.Clonidine (30µg) 0.5cc = 2.5 cc ,Group C (dex) Inj. Bupivacaine 2.0 cc+ Inj. Dexmedetomidine (5µg) 0.5cc= 2.5 .
Statistical Analysis Used: Data analysis was done with Epidemiological Information Package (EPI 2008). ANNOVA t test was used to test the significance of difference between quantitative variables.
Results: Time to peak sensory level and time for Modified Bromage scale – 3 motor block were earlier and statistically significant in Dexmeditomidine group. Time for 2 segment regression, time to regress Modified Bromage 0, time to regress to S1 level, rescue analgesia duration were significantly more in Dexmeditomidine group
Conclusion: Adding 30µg Clonidine or 5µg Dexmedetomidine to 10mg of Bupivacaine significantly prolongs the duration of post operative analgesia when compared to Bupivacaine alone in elective transurethral resection of prostate (TURP) surgeries, without any side effect.
Keywords: Dexmedetomidine, clonidine, adjuvant, bupivacaine, subarachnoid block.
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