Award Papers / Dr Kop's Award

Spinal anaesthesia in children: Comparative study of isobaric levobupivacaine 0.5% with or without clonidine.

Dr.Shubhangi R. Kamble

Indira Gandhi Medical College, Nagpur

Dr. Shubhangi Kamble,Dr. Soma Cham,Dr. S.P. Manjrekar

ABSTRACT :

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

METHODS :

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 with Glycopyrrolate 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.

RESULTS :

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.

CONCLUSIONS :

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.