Indian Journal of Clinical Anaesthesia 2023;10(2):158–162 Content available at: https://www.ipinnovative.com/open-access-journals Indian Journal of Clinical Anaesthesia Journal homepage: www.ijca.in Original Research Article A comparative study of intravenous dexmedetomidine and clonidine as pre-emptive analgesia to intrathecal bupivacaine in subarachnoid block - A randomized double blind study Vidya Shree C 1 , Ravi Madhusudhana 1, * 1 Dept. of Anaesthesiology, Sri Devaraj URS Academy of Higher Education and Research, Sri Devaraj URS Medical College, Kolar, Karnataka, India ARTICLE INFO Article history: Received 28-02-2023 Accepted 13-03-2023 Available online 05-06-2023 Keywords: Pre-emptive Dexmedetomidine Clonidine Bupivacaine ABSTRACT Introduction: Several drugs and drug regimens are used as adjuncts to local anaesthetics for neuraxial blockade in order to enhance its efficacy. In recent times novel drugs, adrenergic agonists like dexmedetomidine and clonidine are extensively used. Very few studies have compared the equipotent doses of both the drugs when given as pre-emptive analgesia. This study compares the efficacy of pre-emptive intravenous dexmedetomidine and clonidine for prolongation of bupivacaine spinal anaesthesia. Materials and Methods: This is a prospective double-blind comparative study conducted at a tertiary care center from January 2021 to May 2022. 90 participants satisfying inclusion criteria were chosen after obtaining ethical Committee approval and informed consent. Study participants were randomly divided into two groups. Group C (n=45) received clonidine 0.5mcg/kg IV and Group D (n=45) received 0.5mcg/kg IV over 10mins following which subarachnoid block was given with hyperbaric bupivacaine 0.5% 15mg intrathecally. The following parameters were measured as onset, duration of sensory and motor blockade, duration of analgesia and number of rescue analgesics given in the postoperative period. Results: Onset of sensory blockade (2.40+ 0.81) and motor blockade (2.78+ 0.88) was significantly faster in group D when compared to group C. Sensory blockade duration in group C and D was (100.22+ 11.38) and (129.33+ 13.55) respectively and was statistically significant. Similarly, Motor blockade duration was prolonged in group D (156.67+ 12.25) than in group C (121.78+ 14.35). Mean duration of analgesia in group D (169.51+19.23) and group C (143.8+18.78) illustrated statistically significant difference. Conclusion: Dexmedetomidine when given as a pre-emptive analgesia enhances the effectiveness of bupivacaine by prolonging its duration of action when compared to clonidine at given doses. This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. For reprints contact: reprint@ipinnovative.com 1. Introduction Regional anesthesia or Neuraxial blockade are extensively used for lower extremities and lower abdominal surgeries. Due to use of minimal drugs, less postoperative pulmonary complications and cost effectiveness, spinal blockade remains first choice. However, shorter duration of anaesthetic blockade is its disadvantages. 1 * Corresponding author. E-mail address: ravijaggu@gmail.com (R. Madhusudhana). To enhance the effectiveness of local anaesthetic agents and prolong the duration of anaesthesia and analgesia various drugs and drug regimens are used as adjuvants like opioids, but it has acute side effects which includes nausea, vomiting, itching, respiratory distress, and urinary statis. 2 Alpha-adrenergic agonists such as dexmedetomidine and clonidine are novel, used through intrathecal, epidural or intravenous route to enhance the effectiveness of subarachnoid block in terms of both sensory and motor blockade. 3,4 https://doi.org/10.18231/j.ijca.2023.031 2394-4781/© 2023 Author(s), Published by Innovative Publication. 158