Original Research Article
Year: 2019 | Month: July | Volume: 6 | Issue: 7 | Pages: 461-467
Comparison of Clonidine and Fentanyl as Adjuvants to Hyperbaric Bupivacaine for Spinal Anaesthesia in Patients Undergoing Transurethral Resection of Prostate: A Prospective Study
Pawan Kumar Gahlawat1*, Usha Sehrawat1**, Naqvi Wajiha Syed Ali Makeen1*, Divya Mahajan1*, Rishi Raj Sanjay2*
1Junior resident, 2Consultant,
*Department of Anaesthesiology & Critical Care, Batra Hospital and Medical Research Centre, New Delhi.
**Department of Otorhinolaryngology, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
Corresponding Author: Usha Sehrawat
ABSTRACT
Background: Spinal anaesthesia is widely used for urological operations particularly in transurethral surgical procedures as it permits early recognition of symptoms caused by over hydration (TURP syndrome) and bladder perforation.
Methods: This study was done over a period of sixteen months in 60 patients (two groups of 30 each) in age group of 50years and above who underwent transurethral resection of prostate (TURP) under spinal anaesthesia. Group A: Patients received intrathecal Bupivacaine 2.2ml with Clonidine 30µg. Group B: Patients received intrathecal Bupivacaine 2.2ml with Fentanyl 20µg. The outcomes for sensory block were observed as time to achieve T10 level, highest level of sensory block and time to achieve it, time to two segment regression of sensory block and regression to T12 level. The outcomes for motor block were observed as time to achieve maximum motor block and time to motor block regression to bromage grade 0. The results was tabulated and statistically analysed using SPSS (Statistical Package for Social Sciences) Software version 15.0, Chi‑square test was used for qualitative data (sex, ASA grade), HR, Mean blood pressure, was compared within the group against baseline values using paired t‑test.
Results: Time to sensory regression to T12 level was found to be significantly (p=0.0001) higher in Group A (120.33±9.46) than Group B (104.33±8.78). The total time of regression to bromage 0 was significantly (p=0.0001) higher in Group A (200.83±17.71) compared to Group B (156.50±13.78). The time of request of analgesia was significantly (p=0.01) higher in Group A than Group B.
Conclusion: As an adjuvant to hyperbaric bupivacaine, clonidine (30 mcg) showed longer duration of sensory block and longer post operative analgesia when compared to fentanyl (20mcg) in subarachnoid block for trans-urethral resection of prostate.
Key words: spinal anaesthesia; clonidine; fentanyl; hyperbaric bupivacaine; TURP
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