BACKGROUND AND AIMS:Spinal anaesthesia requires a small volume of drug to produce profound reproducible sensory analgesia and motor blockade, but has limited duration of action. A properly chosen adjuvant to local anaesthetic agent produces the best way to achieve a better quality regional block. Hence, a study was conducted to compare the effect of intrathecal clonidine 75 μg or neostigmine 50 μg added to intrathecal hyperbaric bupivacaine, with regards to sensory characteristics, motor characteristics, haemodynamic stability and side effects.METHODS:This was a prospective randomized experimental study in 50 patients posted for lower abdominal surgery belonging to ASA I and II status and aged between18 and 60 years. One group received intrathecal clonidine 75 μg and 2.5 ml (12.5 mg) of intrathecal 0.5% hyperbaric bupivacaine (group BC) and second group received neostigmine 50 μg with 2.5 ml (12.5mg) of intrathecal 0.5% hyperbaric bupivacaine (group BN) and they were compared with regards to sensory characteristics, motor characteristics, haemodynamic stability and side effects.RESULTS:Addition of 50 μg neostigmine significantly enhanced the onset of sensory block (BN - 90 ± 15 secs, BC-160 ± 20 secs, P value as <0.05) and motor block (BN-110 ± 15 secs, BC-210 ± 20 secs, P value as <0.05) compared to clonidine. Haemodynamics were well maintained in the neostigmine group. Group BC had prolonged analgesia (362 ± 36 mins) compared to BN group (300 ± 25 mins)(P < 0.05) with no serious adverse effects noted perioperatively in either groups.CONCLUSION:Intrathecal clonidine with hyperbaric bupivacaine produces prolonged postoperative analgesia and intrathecal neostigmine with bupivacaine produces a good sensory and motor for the surgical procedure.

Effective analgesia peri operatively is very much essential for managing any type of surgical cases. Opioid was commonly employed for managing these cases. Due to its known side effects, an alternative drug was selected and studied. Hence, we compare the quality and side effects of NSAIDs- paracetamol versus diclofenac infusion for peri operative analgesia. Sixty ASA I & II patients undergoing lower abdominal surgery was randomly selected and divided into two groups. Both groups were assessed and general anaesthesia was given. At the time of rectus abdominis muscle closure, Group P received paracetamol infusion and Group D received diclofenac infusion. Post operatively all patients were monitored, pain was assessed with VAS score and side effects were also noted. VAS score > 7 received rescue analgesics and results were tabulated. Most of the patients in paracetamol group had VAS score <7 for more than 5 hours after the surgery. The time to first request for rescue analgesia after injection of study drug was approximately 3 times as long with paracetamol compared to diclofenac, with no serious complications noticed. This indicates that i.v paracetamol infusion has better analgesia than i.v diclofenac infusion for acute post operative pain.

Recent years have seen a great re-awakening of interest in sub arachanoid blockade. Various drugs have been used along with local anaesthetics for prolongation of spinal analgesia like opiates, benzodiazepines, neostigmine etc. Many of these drugs have serious adverse effects like respiratory depression, pruritus, vomiting etc. A properly chosen adjuvant to local anaesthetic agent produces the best way to achieve a good quality regional block. To compare the effect of intrathecal Clonidine 75 micrograms (µg) to 2.5 milliliter (ml) of 0.5% hyperbaric Bupivacaine, with regards to 1) Sensory characteristics, 2) Motor characteristics, 3) Side effects. we performed this study on a patients posted for lower abdominal surgery belonging to ASA I and age group between18-60 years after obtaining an written informed consent and ethical clearance. Sample size 50. Addition of preservative free Clonidine 75µg to intrathecal hyperbaric Bupivacaine (0.5%) significantly produces prolongation of analgesia (327±30mins) than compared to the control Bupivacaine group of only 167±25mins with no serious adverse effect noted perioperatively. With this study we conclude intrathecal Clonidine in the dose of 75µg along with 2.5 ml of 0.5% hyperbaric Bupivacaine provides an attractive alternative combination to anesthesiologist