A Comparative Study between Low Dose Bupivacaine-Fentanyl and Bupivacaine-Clonidine with Plain Bupivacaine in Spinal Anaesthesia in Orthopaedic Patients

60 adults of either sex belonging to American Society of Anesthesiologists (ASA) Class I & II, scheduled for lower limb and hip surgery under subarachnoid block were enrolled in the randomized and double blind controlled study. Patients were randomly allocated to three groups consisting of 20 patients each (Groups B, C and F). Group B (Bupivacaine) received an intrathecal injection of 2.5ml of 0.5% hyperbaric bupivacaine with 0.5ml of normal saline. Group C (Clonidine) received an intrathecal injection of 2.5ml of 0.5% hyperbaric bupivacaine with 30mcg of clonidine in 0.5ml of normal saline and Group F (Fentanyl) received an intrathecal injection of 2.5ml of 0.5% hyperbaric bupivacaine with 25mcg of fentanyl in 0.5ml of normal saline. Significant difference among the three study groups was observed in the time of two segment regression and duration of motor block (regression to Bromage 0). There was a significant difference regarding time to rescue analgesia and the total dose of rescue analgesics required during the postoperative 24 hours in groups C and F as compared to group B. Our study demonstrated that the use of intrathecal fentanyl and clonidine as adjuvants to hyperbaric bupivacaine in orthopaedic surgical procedures provides good quality intraoperative analgesia and hemodynamic stability with minimal side effects and excellent quality of postoperative analgesia.