European Journal of Molecular & Clinical Medicine

Abstract

Background: Bupivacaine, the commonly used local anesthetic agent in spinal anaesthesia having
duration of sensory and motor blockade of 90 to 200minutes limits its use for short duration ambulatory
surgery with delayed ambulation and risk of urinary retention. But 2-Chloroprocaine (2-CP) has
duration of action of 70 to 150 minutes. With Clonidine, an α2-adrenergic agonist, as an adjuvant has
been shown to prolong both the sensory and motor blockade when combined with spinal Bupivacaine.
In our study, we compared the effectiveness of intrathecal 1% 2-Chloroprocaine with clonidine vs.
intrathecal 1% 2- Chloroprocaine for infraumbilical surgeries in terms of their onset of blocks, duration
and offset of blocks along with the hemodynamic variations.
Methods: A prospective and omised controlled double blind study was conducted in 60 ASA I and
ASA II patients in the age group 18-60 years, posted for elective infraumbilical surgeries under
subarachnoid block. They were randomised into 2 groups of 30 patients each and Group CC (n=30)
received intrathecal 3.0 ml of 1% 2-CP with 30 mcg Clonidine and Group CS (n=30) received
intrathecal 3.0 ml of 1% 2-CP with 0.2ml Normal Saline. Hemodynamic parameters, onset of sensory
blockade, time for highest sensory and motor blockade, total duration of sensory an motor blockade,
two dermatome regression time, time for rescue analgesic, time for ambulation and first micturition,
sedation score were recorded. Side effects werenoted.
Results: Demographic data as well as operating data were comparable between the 2 groups. Group
CC showed faster offset and prolonged sensory and motor blocks compared to Group CS. Time for
ambulation and micturition were less in Group CS compared to Group CC. No side effects were note
din both the groups.
Conclusion: Addition of clonidine to Intrathecal isobaric 2-chloroprocaine decreases the onset time for
sensory and motor blockade, produces higher level of sensory blockade, prolongs postoperative
analgesia, prolongs sensory blockade and motor blockade, prolongs ambulation and voiding time and
has less haemodynamic changes which could be easily managed. Hence it may be proposed for day
care surgeries.