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Lavanya M. P

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2026

A PROSPECTIVE RANDOMIZED COMPARATIVE STUDY OF CLONIDINE VERSUS FENTANYL AS ADJUVANTS TO EPIDURAL BUPIVACAINE IN PATIENTS UNDERGOING ELECTIVE LOWER LIMB SURGERIES

Background: Epidural adjuvants improve the quality and duration of analgesia while reducing the dose requirement of local anaesthetics. Clonidine and fentanyl are commonly used epidural adjuvants, but their comparative efficacy remains a subject of interest. This study aims to compare the effects of clonidine and fentanyl as adjuvants to epidural bupivacaine in patients undergoingelective lower limb surgeries.Materials and Methods: This prospective, randomized comparative study was conducted over 18 months and included 60 ASA physical status I and II patients aged 18–60 years undergoing elective lower limb surgeries. Patients were randomly allocated into two groups (n = 30 each). Group BC received 16 mL of 0.5% isobaric bupivacaine with clonidine (1 μg/kg), while Group BF received 16 mL of 0.5% isobaric bupivacaine with fentanyl (0.5 μg/kg). The primary outcomes included onset and duration of sensory and motor block, and secondary outcomes included time to two-segment regression, duration of postoperative analgesia, haemodynamic parameters, sedation score, and adverse effects.Results: Group BF demonstrated a significantly faster onset of sensory block (6.3 ± 0.79 vs. 11.5 ± 0.82 minutes) and motor block (16.9 ± 1.32 vs. 24.2 ± 1.10 minutes) compared with Group BC (p < 0.001). However, Group BC showed significantly prolonged two-segment regression time (268.2 ± 0.38 vs. 109.2 ± 0.27 minutes), duration of sensory block (307.8 ± 0.47 vs. 147.0 ± 0.34 minutes), duration of motor block (292.8 ± 0.42 vs. 133.8 ± 0.35 minutes), and time to first rescue analgesia (307.8 ± 0.47 vs. 207.6 ± 0.34 minutes) (p < 0.001 for all comparisons). The incidence of adverse effects, including hypotension, bradycardia, and nausea/vomiting, was comparable between the two groups (p = 1.000).Conclusion: Epidural clonidine (1 μg/kg) as an adjuvant to bupivacaine provided significantly prolonged sensory and motor blockade and longer postoperative analgesia than epidural fentanyl (0.5 μg/kg), without increasing adverse effects. Therefore, clonidine may be considered an effective and safe alternative to fentanyl for epidural anaesthesia in elective lower limb surgeries.

Lavanya M. P, Harini Priyadarshini M. S, Amarnath C et al. · Asian Journal of Medical Res... · 0 citations

2026

COMPARATIVE EVALUATION OF INTRATHECAL BUPIVACAINE (0.5% HEAVY) WITH MIDAZOLAM 1 MG VERSUS 2 MG AS AN ADJUVANT IN SUBARACHNOID BLOCK FOR ELECTIVE LOWER ABDOMINAL SURGERIES

Background: Spinal anaesthesiais widely used for lower abdominal surgeries due to its rapid onset and effective analgesia. However, limited duration of action remains a concern. Intrathecal midazolam, acting via GABA receptors, has been shown to enhance analgesic effects when used as an adjuvant to bupivacaine. This study aims to compare the efficacy and safety of two doses (1 mg and 2 mg) of intrathecal midazolam combined with 0.5% hyperbaric bupivacaine.Methods: 80patients (ASA I–II, aged.18–60) undergoing elective lower abdomen operations participated in a prospective, randomised, single-centretrial. Two groups of patients were created: bupivacaine and 1 mg of midazolam were given to Group M1, while bupivacaine and 2 mg of midazolam were given to Group M2. The onset and duration of sensory and motor block, sedation scores, time to rescue analgesia, haemodynamic alterations, and side effects were among the parameters evaluated. The t-test and chi-square test were used for statistical analysis, with significance set at p<0.05.Results: Group M2 showed significantly faster onset of sensory (1.23 vs 1.78 min) and motor block (1.78 vs 2.25 min). The duration of sensory and motor block was significantly prolonged in Group M2 (191.25 vs 154.13 min and 238.35 vs 196.50 min, respectively). Time to rescue analgesia was longer in Group M2 (272.73 vs 235.88 min). Sedation scores were higher in Group M2 but remained clinically acceptable. Hemodynamic parameters were stable and comparable in both groups, with minimal and statistically insignificant adverse effects.Conclusion: Intrathecal midazolam 2 mg as an adjuvant to 0.5% hyperbaric bupivacaine provides superior analgesia, prolonged block duration, faster onset, and acceptable sedation without significant adverse effects compared toa1 mg dose.

Ashmi Samad, Harini Priyadarshini M.S, Srija P et al. · Asian Journal of Medical Res... · 0 citations