A Comparative Study of Efficacy of Clonidine and Fentanyl as Adjuvant to Intrathecal 2- Chloroprocaine in Lower Limb Surgeries: A Randomized, Double-Blind Trial

BACKGROUND: Preservative free 1% 2-chlorprocaine is a short acting local anesthetic agent that has a favourable profile for day care surgical procedures. Various adjuvants can be added to local anesthetics to potentiate their action. In this study, we compared the effect of intrathecal clonidine and fentanyl as an adjuvant to 1% 2-chloroprocaine (2-CP) in patients undergoing elective lower limb surgeries.

MATERIAL AND METHODS: Seventy patients of American Society of Anesthesiologists (ASA) grade 1 and 2 (18-60 years) scheduled for lower limb surgeries with duration of ≤60 minutes under spinal anesthesia were randomly divided into 2 groups (n= 35). Group CF received 1% 2-chloroprocaine 40 mg and fentanyl 20µg (4.5 ml). Group CC received 1% 2-chloroprocaine 40 mg and clonidine 15µg (4.5 ml). The onset and duration of sensory and motor blocks, time for demand of rescue analgesia, hemodynamics, and side effect, if any, were observed.

RESULTS: The onset and duration of sensory and motor blocks was significantly earlier in CC group. Time to demand of rescue analgesia was significantly prolonged in Group CC than CF.  Other side effects were comparable in two groups

CONCLUSION: Intrathecal clonidine (15 μg) is a better alternative to fentanyl (20 μg) used as an adjuvant to 1% 2-chloroprocaine for lower limb surgeries surgeries.