Comparative Study of the Effect of Clonidine and Butorphanol as Adjuvant to Intrathecal Bupivacaine for Post Operative Analgesia in Lower Abdominal and Lower Limb Surgeries

Background: Intrathecal adjuvants to local anesthetic enhance the quality and duration of spinal anaesthesia. The present study was aimed to comparatively evaluate clonidine and butorphanol as adjuvants to intrathecal hyperbaric bupivacaine for subarachnoid blockade during lower abdominal and lower limb surgeries.Patients and Method: Sixty adult consented patients, undergoing elective lower-abdominal and lower-limb surgeries under subarachnoid blockade, were inducted in a blind randomized prospective study conducted in the Department of Anesthesia, GMC Jammu and allocated into 2 equal groups to receive either 3.2 ml of 0.5% hyperbaric bupivacaine (16mg) with 0.2 ml of Clonidine 30 µgm (Group I) or with 0.2 ml of Butorphanol 200 µgm (Group II). Patients were compared for the onset and duration of sensory and motor blockade, intraoperative hemodynamic changes, time to first rescue analgesia, etc.Result: The mean onset time of sensory block was 3.18±0.56 min in Group I and 3.69±0.83 min in Group II. Complete motor block was achieved in 11.53±3.05 min in Group I and in 12.72±3.17 min in Group II, with no significant difference. (p = 0.138) The duration of motor block was 294.28±33.85 min in Group I, as compared to patients of butorphanol group 245.71±30.92 min,(p = 0.046). The need for rescue analgesia was significantly earlier in Group II, ie at 211.09±20.74 min, while at 256.32±24.40 min in group I.Conclusion: Clonidine and butorphanol are good adjuvants to hyperbaric bupivacaine for spinal anaesthesia. Clonidine provides longer duration of sensory and motor blockade and prolonged duration of postoperative analgesia compared to butorphanol.Keywords: Spinal Anesthesia, Clonidine, Butorphanol, Intrathecal Adjuvants, Subarachnoid Blockage.