A Comparative Study of Efficacy of Clonidine and Fentanyl as Adjuvant to Intrathecal ۲- Chloroprocaine in Lower Limb Surgeries: A Randomized, Double-Blind Trial

Background: Preservative-free, ۱% ۲-chloroprocaine, is a short-acting local anesthetic agent with a favorable profile for daycare 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 ۱% ۲-chloroprocaine (۲-CP) in patients undergoing elective lower limb surgeries. Materials and Methods: Seventy patients of the American Society of Anesthesiologists (ASA) grade ۱ and ۲ (۱۸-۶۰ years) scheduled for lower limb surgeries with a duration of ≤۶۰ minutes under spinal anesthesia were randomly divided into two groups (n= ۳۵). Group CF received ۱% ۲-chloroprocaine ۴۰ mg and fentanyl ۲۰μg (۴.۵ ml). Group CC received ۱% ۲-chloroprocaine ۴۰ mg and clonidine ۱۵μg (۴.۵ ml). The onset and duration of sensory and motor blocks, time for the demand of rescue analgesia, hemodynamics, and side effects were observed. Results: The onset and duration of sensory and motor blocks were significantly earlier in the CC group. Time to demand rescue analgesia was significantly prolonged in Group CC than in CF. Other side effects were comparable in the two groups. Conclusion: Intrathecal clonidine (۱۵ μg) is a better alternative to fentanyl (۲۰ μg) used as an adjuvant to ۱% ۲-chloroprocaine for lower limb surgeries.