Epidural Clonidine as an Adjuvant to Local Anesthetic in Lower Abdominal and Lower Limb Surgeries: A Randomised Controlled Study

Palak Arora1, Jesni Joseph2, Madhusudan Upadya3, Sonal Bhat3, *
1 Department of Anesthesia, Fortis Hospital, New Delhi, India
2 Department of Anesthesia, Royal Oman Police Hospital, Muscat, Oman
3 Department of Anaesthesiology, Kasturba Medical College, Manipal University, Mangaluru, Karnataka, India

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© 2020 Arora et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at Department of Anaesthesiology, Kasturba Medical College, Manipal University, Mangaluru, Karnataka, India; Mob No: 9980014995, E-mail:



Acute pain leads to adverse physiological and psychological disturbances. Hence, this study was done to evaluate and compare the onset and duration of sensory anesthesia, motor paralysis and duration of analgesia using 0.5% plain bupivacaine, with clonidine (2μg/kg) in patients posted for lower abdominal and lower limb surgeries under epidural anaesthesia.

Materials and methods:

62 Patients posted for elective lower abdominal, gynaecological and lower limb surgeries under epidural anesthesia, aged 18 to 60 years, height more than 150 cms of ASA physical status 1 or 2 were included. All patients were randomized into two groups of 31 individuals each.


Clonidine in the dose of 2μg/kg added to bupivacaine injected into epidural space significantly prolonged the duration of analgesia when compared to bupivacaine alone. No effect on the onset of sensory and motor blockade was observed. However, it increases the duration of motor blockade. Clonidine also has effect on sedation level, pulse rate and mean arterial blood pressure.


Clonidine causes increased sedation; fall in pulse rate and mean arterial blood pressure, which however, did not require active intervention in this study.

Keywords: Epidural clonidine, Local anesthetic, Postoperative analgesia, Lower Abdominal, Lower limb surgeries, Acute pain.