OBJECTIVE: To study the effect of clonidine added to 0.5% levobupivacine for spinal anaesthesia in children for infra-umbilical surgeries.

METHOD: After ethical committee approval, necessary investigations & informed written consent obtained from parents/guardians of all the patients, ASA I/II patients, of 5-10 yrs, posted for infra-umbilical surgeries were included. All were premedicated withGlycopyrrolate 5mcg/kg and Midazolam 0.08mg/kg IM. Lumbar puncture performed under the effect of propofol 0.5-1mg/kg followed by infusion of 2-4mg/kg/ hr. They were randomly allocated into two groups to receive: Group A – Intrathecal isobaric 0.5% levobupivacaine as per weight of patient. Group B – Intrathecal isobaric 0.5% levobupivacaine as per weight of patient with Clonidine 1mcg/kg. (<5 kg – 0.5 mg/kg, 5-15 kg – 0.4 mg/kg, 15-40 kg – 0.3 mg/kg- levobupivacaine) Blockade characteristics, haemodynamic variables, sedation score, FLACC score monitored. Any side effects and complications noted and treated.

RESULT: Addition of clonidine to levobupivacaine hastened the onset of analgesia. A longer duration of sensory block along with extended duration of post-operative analgesia noted. Propofol requirement for sedation were comparatively less in patients receiving Intrathecal clonidine.

DISCUSSION: Spinal anaesthesia in paediatrics is a safe alternative to GA for infra- umbilical procedures, as it produces profound analgesia and good muscle relaxation avoiding respiratory complications associated with GA, the limitation being duration of analgesia. Clonidine as spinal adjuvant prolongs analgesic duration without additional side-effects.

CONCLUSION: Clonidine as an adjuvant to intrathecal isobaric levobupivacaine in spinal anaesthesia, decreases the time for surgical incision, produces longer duration of both surgical anaesthesia & post-operative analgesia with comparable side-effects.