Comparison of Clonidine versus Fentanyl as an Adjuvant to Intrathecal Ropivacaine for Intraoperative Efficacy and Post Operative Analgesia in Infraumblical Surgeries

Background Ropivacaine is a newer local anesthetic, proven to have a better safety margin than bupivacaine and lignocaine. While maintaining this advantage and improving the intraoperative quality of anesthesia, the use of analgesic adjuvants has been proven to be valuable. Aim& objective Comparison of clonidine versus fentanyl as an adjuvant to intrathecal ropivacaine for intraoperative efficacy and post operative analgesia in infraumblical surgeries. Settings and Designs Randomized double-blind control trial. Methodology Seventy patients were randomly divided in two groups. Ropivacaine-Clonidine group (RC) received 60 mcg of clonidine with 15 mg of 0.5 % isobaric ropivacaine, Ropivacaine Fentanyl group (RF) received 25 mcg of fentanyl with 15 mg of 0.5 % isobaric ropivacaine intrathecally. The onset and duration of sensory-motor block were recorded. The total analgesia time, sedation score, hemodynamic parameters, and side-effects were noted. . Result The duration of sensory block in RC (316 21.9), RF (227 26, 3), and motor block in RC (247 28.4), RF (199.3 20.2). In clonidine group, there was significant prolongation of sensory block (P less than 0.001), motor block (P less than 0.001) and the total analgesia time (P less than 0.001). Hypotension and bradycardia occurred in 8.6 % and 11.4 % respectively in patients of clonidine group, where as pruritis was experienced by 11.4 % patients in fentanyl group. Conclusion Ropivacaine when combined with clonidine or fentanyl provided adequate subarachnoid block for infraumblical surgeries, where in clonidine has advantage over fentanyl as it increased the duration of subarachnoid block and prolonged the postoperative analgesia.