Opioids and alpha-2 agonists are being increasingly used as adjuvants for epidural anaesthesia.The present study aims at comparing the haemodynamic,sedative and anlgesia potentiating effects of epidurally administered dexmedetomidine and clonidine assosciated to bupivacaine.

After obtaining Institutional ethical clearance and informed consent,60 patients aged 21-56 years,ASAI and II, posted for lower abdominal surgeries recieved epidural anaesthesia with 20cc of 0.5% isobaric bupivacaine ,adjuvant being dexmedetomidine 1μg/kg /kg in Group 1(30 patients)and Clonidine 1.5μg/kg Group 2(30 patients).Besides haemodynamic variables, time to onset of analgesia at T10, maximum sensory analgesic level, time to complete motor blockade,sedation score and time to first rescue analgesia were observed

The demographic profile of patients was comparable in both the groups. Onset of sensory analgesia at T10 (7.12±2.44 vs 9.14±2.94),time for maximum sensory level(13.3±4.48 vs 16.4±4.3) and establishment of complete motor blockade (18.16±4.52 vs 22.98±4.78) was significantly earlier in the group1. Postoperative analgesia was prolonged significantly in the group1 (400.62±24.42 vs 345±14).Ramsay sedation scores were much better in group1(36%vs16%) and highly significant on statistical comparison (P<0.001).The incidence of side effects like nausea, vomiting, headache, shivering and dizziness were comparable in both the groups and statistically non-significant(P > 0.05). We did not observe respiratory depression in any patient from either group.

Dexmedetomidine is a better neuraxial adjuvant compared to clonidine for providing early onset of sensory analgesia, adequate sedation and a prolonged post-operative analgesia