COMPARISON OF EPIDURAL DEXMEDETOMIDINE AND CLONIDINE AS ADJUVANT TO BUPIVACAINE FOR ABDOMINAL HYSTERECTOMY -A RANDOMISED DOUBLE BLIND CONTROLLED STUDY

Background Epidural anesthesia is useful for providing both intraoperative anesthesia and postoperative analgesia. It provides intra operative hemodynamic stability, reduce perioperative stress response, helps in early mobilisation and thereby reducing complications and improving patient outcome. e quality and duration of analgesia is improved, when a local anesthetic is combined with alpha 2 adrenergic agonist. Aim of our study was to compare epidural dexmedetomidine and clonidine as an adjuvant to bupivacaine with respect to perioperative block characteristics, postoperative analgesia, sedation and hemodynamic profile. Methodology In our study, 90 patients of American Society of Anaesthesiologists grading I/ II of ages between 35-55 years posted for elective abdominal hysterectomy, were selected. e patients were randomly divided into three groups. Group B received 10 ml of 0.5% Bupivacaine+1ml of saline, Group BD received 10 ml 0.5% Bupivacaine plus 1.5 μg/kg Dexmedetomidine & Group BC received 10ml 0.5% Bupivacaine plus 2 μg/kg Clonidine epidurally. Hemodynamic parameters, sedation scores & block characteristics were studied. Results e demographic profile, duration of surgery and side effects were comparable and statistically non-significant in all the three groups. Onset of sensory analgesia at T10 and establishment of complete motor blockade was significantly earlier in the BD group. Postoperative analgesia was prolonged significantly in BD group than BC & B group and consequently less epidural top-ups in the first 24 hours. Conclusion Dexmedetomidine & clonidine have synergistic action with bupivacaine, when administered epidurally. Dexmedetomidine has a slightly better adjuvant profile compared to clonidine providing early onset of sensory & motor block, adequate sedation and prolonged postoperative analgesia.