To study efficacy and safety of addition of intrathecal clonidine and midazolam to hyperbaric bupivacaine added as an adjuvant for post operative analgesia

Introduction: We compared the effects of addition of intrathecal clonidine and midazolam to 0.5% hyperbaric bupivacaine in terms of efficacy of sensory and motor block achieved and observed the side effects if any. Methods: Forty patients of ASA Grade I and II between 18 – 60 years age of either sex undergoing lower limb surgeries were randomly allocated to any of the groups of 20 each by lottery method. Group M: Patients received Midazolam 2.5 mg preservative free (0.5 ml). Group C: Patients received Clonidine 75 micrograms (0.5 ml). These drugs were given with bupivacaine 15 mg (3 ml of 0.5 % hyperbaric solution) intrathecally. The time of onset, peak sensory and motor, 2 segment regression, time of rescue analgesia, haemodyanmic changes and any other side effect were recorded. Results: The motor blockade was significantly prolonged in group C (809.56  290.38) than group M (533.80  164.91). Two segment sensory regression, motor regression and time of rescue analgesia in group C (110.44  28.77, 411.11  82.07, 8.69  0.92) was significantly more as compared to group M (66.10  10.15, 159.80  35.28, 4.28  0.7) suggesting prolonged analgesia in intra-op & post-op periods. Conclusion: 75 micrograms clonidine when added to 0.5% hyperbaric bupivacaine prolongs the sensory and motor block and reduces requirement of rescue analgesia as compared to 2.5mg midazolam.