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Background and Aim: Our aim was to compare the analgesic efficacy following intrathecal administration of dexmedetomidine or clonidine as adjuvant with isobaric ropivacaine in lower limb orthopaedic surgery. Methods: Ninety patients of ASA grade I or II, ages between 20-60 years, were randomly allocated to three equal groups, Group R received 2.5ml of isobaric ropivacaine (0.75%) with normal saline as a placebo, group D received 2.5ml of isobaric ropivacaine (0.75%) with 5 μg of dexmedetomidine and Group C received 2.5ml of isobaric ropivacaine (0.75%) with 30 μg of clonidine. All solutions were made up to 3 ml with addition of normal saline. The onset and duration of sensory and motor blockade, time to reach peak sensory and motor level and the sensory and motor regression times were recorded. Time to use first rescue analgesia, hemodynamic changes and side effects were recorded. Results: Time to onset of sensory block and motor block was early in Group D and Group C as compared to Group R. Duration of sensory and motor blockade was prolonged in Groups C and D compared with Group R. The mean regression time to S1 segment was prolonged in Group D, and in Group C compared to Group B. The time to 1st rescue analgesia was significantly prolonged in Group D compared with Group C and group R. Conclusion: The addition of dexmedetomidine to intrathecal ropivacaine prolongs the sensory block and provides prolonged postoperative analgesia when compared to ropivacaine with or without clonidine in lower limb orthopaedic surgeries.

Dexmedetomidine and clonidine as intrathecal adjuvants to 0.75% isobaric ropivacaine in lower limb orthopaedic surgery