Comparative Evaluation of Analgesic E?cacy of Intra-Articular Vs Intrathecal Clonidine in Arthroscopic Anterior Cruciate Ligament Repair: A Randomised, Double Blind Prospective Study

Arthroscopic Anterior Cruciate Ligament Repair

Abstract

Background: The purpose of this study was to compare the analgesic effects of Clonidine as an adjuvant through different routes for ACL repair surgeries. Subjects and Methods: Ninety adult patients of ASA grade I and II, both sex, age 18-60 years scheduled for ACL repair under Sub-arachnoid block (SAB) were randomly allocated into three groups. All patients received 0.5% bupivacaine intrathecally as in control group. Group IT received 1 g/kg of clonidine in saline intrathecally with hyperbaric bupivacaine. Group IA received Clonidine 1g/kg with 30 ml saline injected intra-articularly at the end of surgery. The duration of analgesia and block characteristics were the primary outcomes studied. Results : Statistical analysis was done by Statistical Package for Social Sciences (SPSS version 20.0) and epi info 7 (CDC Atlanta). The mean duration of Analgesia in Group IA(5.9  1.02h) was significantly (p=0.01) longer than that of Group IT(5.2  0.85h) and Group C (4.0  0.78h) and the requirement of total number of rescue analgesics in 24 hr period was lesser in Group IA(1.1  0.33) and Group IT (1.3  0.50) than  Group C (3.4 0.69). The mean duration of sensory and motor block in Group IT was (4.5 0.88 h) and (3.8 0.78 h) respectively which was significantly longer than other groups. Conclusion: Clonidine is a useful adjuvant in prolonging analgesia through various routes for ACL repair surgeries arthroscopically. Intra-articularly administered clonidine provided most effective postoperative analgesia with least hemodynamic changes and complications.