Comparison of the Effect of Dexmedetomidine and Clonidine as an Adjuvant to Epidural Levobupivacaine on Duration of Post-Operative Analgesia in Total Abdominal Hysterectomy-A Randomized Controlled Trial
DOI:
https://doi.org/10.67440/ahj.vi.2711Keywords:
local anesthetics, dexmedetomidine, clonidine, analgesia, Postoperative pain, epidural anesthesia.Abstract
Background: The combination of local anesthetics with α2-adrenergic agonists enhances both quality and duration of analgesia. clonidine has been extensively studied, but dexmedetomidine remain limited. This study aims to compare clonidine and dexmedetomidine as adjuvants to epidural levobupivacaine in patients undergoing total abdominal hysterectomy. The primary objective was to compare the effects of dexmedetomidine and clonidine as adjuvants to epidural levobupivacaine on the duration of postoperative analgesia.
Materials and methods: Patients were randomized into two groups - Group C received 15 ml of 0.5% levobupivacaine with 1 mcg/kg clonidine epidurally. Group D received 15 ml of 0.5% levobupivacaine with 1 mcg/kg dexmedetomidine epidurally. Postoperative pain was evaluated using the Visual Analog Scale (VAS). Onset of sensory blockade, motor blockade and the total number of 0.125% levobupivacaine boluses administered on postoperative day 0 (POD 0) were also recorded.
Result: Group C (clonidine) had a significantly longer duration of analgesia than Group D (dexmedetomidine) (452.5 vs 371.2 minutes, p < 0.001). Group D showed a faster onset and wider spread of sensory block, as well as more intense motor blockade (T6– T12, p < 0.001). Analgesic requirements on POD 0 were comparable between groups. Hemodynamic stability was significantly better in Group D from 5 to 120 minutes intraoperatively (p < 0.001). Heart rate was stable in Group D across all time intervals (p < 0.01).
Conclusion: Dexmedetomidine at a dose of 1 mcg/kg is an effective adjuvant to levobupivacaine for epidural anesthesia, which is comparable to clonidine.
CTRI number: CTRI/2025/07/090145, date: 03-07-2025, Online link:
