Background: Epidural anesthesia is a widely used anesthesia technique commonly for surgeries involving the lower extremities up to the abdomen.It is beneficial for long duration surgeries because the epidural catheter in place allows additional of local anesthetic as needed. However, this technique has a slower onset of action and requires a larger volume of local anesthetic compared with spinal anesthesia. This study aims to determine if clonidine when used as an adjuvant can hasten the onset of action of levobupivacaine epidural anesthesia thus allowing the early commencement of surgery. Methodology: This is a double blind randomized controlled trial. After approval from the institution‘s research ethics and review committee,a total of 36 patients of American Society of Anesthesiologist ClassificationI or II for elective lower limb orthopedic surgery under levobupivacaine epidural anesthesia were purposively enrolled in this study and randomly assigned by match pairing of characteristics to two groups: GroupA—Clonidine and Group B—plain normal saline solution. Group A were given 0.5% levobupivocaine 15cc with 30 yg (0.2cc) clonidine and groupB were given 0.5% levobupivocaine 15cc with 0.2cc plain normal saline solution. In both groups the onset of levobupivacaine epidural anesthesia (sensory block atT10dermotomal level/Bromage 1) were observed. Side effects such as hypotension, decreased in respiratory rate, oxygen saturation, and any untoward incidence were noted. All data gathered: statistical mean, median, standard deviation, and T test were analyzed using the SPSS software at 5% significance level. Results: The mean onset of action of group A— Clonidine group (5.62 minutes) was foster compared to group B—control (11.33 minutes), which was statistically significant (P«0.05). The highest dermotomal level for the clonidine group was at T6 and T7forthecontrol group. Two segments regression was at 180 minutes forthe Clonidine group while 60 minutes for the control group. The patients given clonidine experienced side effects such as sedation, bradycardio (20% decrease in cardiac rote from baseline), and shivering. Hypotension was not observed in both clonidine and control groups. Conclusion Clonidine ata dose of30 |Jgwhen used as an adjuvant to levobupivacaine epidural anesthesia can hasten its onset of action among patients undergoing elective lower limb orthopedic surgery.
Anesthesia, Epidural ; Clonidine