A comparison of fentanyl and clonidine as adjuvants to intrathecal levobupivacaine for spinal anaesthesia and postoperative analgesia in patients undergoing for lower limb surgery

Objective: Analgesic adjuvants, clonidine and fentanyl have decreased the requirements the local anaesthesia and prolonged the effects of the analgesia. The purpose of this study was compare the intrathecal clonidine and fentanyl as adjuvant to levobupivacaine in terms of efficacy, safety and postoperative analgesia in patients undergoing lower abdominal surgeries. Methods: This prospective study is conducted is sixty lower limb surgery patients, divided into two group C: 2.5ml of 0.5% levobupivacaine with either 30μg of clonidine and group F: 2.5ml of 0.5% levobupivacaine with either 15μg of fentanyl intrathecally. The hemodynamic parameters, onset and duration of sensory and motor block, total analgesia time and side effects were statistically analyzed using unpaired  t -tests and Chi-square test. Results : The onset of sensory and motor were statistically similar in both group F and group C. The duration of sensory and motor block were significantly higher (p <0.001) in group C as compared to group F. The highest level sensory block was comparable in both group (p=0.918). Time reach max level and rescue analgesia were higher in group C (146.33±10.44 and 513.33±22.18 respectively) as compared to group F (139.17±7.09 and 428.50±25.53 respectively). Conclusions: Intrathecal clonidine and fentanyl as adjuvant to levobupivacaine provide adequate anaesthesia for lower abdominal surgeries. Clonidine as an adjuvant provided prolonged postoperative analgesia as compared to fentanyl.