International Journal of Medical and All Body Health Research  |  e-ISSN: 2582-8940  |  Double-Blind Peer Review  |  Open Access  |  CC BY-NC-SA 4.0

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     2026:7/4

International Journal of Medical and All Body Health Research

e-ISSN: 2582-8940 | Open Access

Comparative Evaluation of Intrathecal Clonidine and Nalbuphine as an Adjuvant to Hyperbaric Ropivacaine in Subarachnoid Block

Dr. Ankur Sehgal, Dr. Keshav Dev Jagar, Dr. Lokesh Kumar Gupta, Dr. Shailja Sharma, Dr. Sharad Goel, Dr. Nikhil Vaid, Dr Manish Madhrey

Post Graduate Resident, Department of Anaesthesia and Critical Care, Saraswathi Institute of Medical Sciences, Pilkhuwa, Hapur, Uttar Pradesh, India; Associate Professor, Department of Anaesthesia and Critical Care, Saraswathi Institute of Medical Sciences, Pilkhuwa, Hapur, Uttar Pradesh, India; Professor, Department of Anaesthesia and Critical Care, Saraswathi Institute of Medical Sciences, Pilkhuwa, Hapur, Uttar Pradesh, India; HOD & Professor, Department of Anaesthesia and Critical Care, Saraswathi Institute of Medical Sciences, Pilkhuwa, Hapur, Uttar Pradesh, India; Assistant Professor, Department of Anaesthesia and Critical Care, Saraswathi Institute of Medical Sciences, Pilkhuwa, Hapur, Uttar Pradesh, India; Senior Resident, Department of Anaesthesia and Critical Care, Saraswathi Institute of Medical Sciences, Pilkhuwa, Hapur, Uttar Pradesh, India

Article Information

Volume / Issue6 / 3 (July-September 2025)
Pages82-88
AccessOpen Access

Publication Timeline

  • Received10 June 2025
  • Accepted11 July 2025
  • Published

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Abstract

Subarachnoid block is a widely used anesthetic technique for lower abdominal and lower limb surgeries. Adding adjuvants to local anesthetics enhances block quality and prolongs postoperative analgesia. This prospective, randomized, double-blind study compared the efficacy of intrathecal clonidine versus nalbuphine as adjuvants to hyperbaric ropivacaine. Ninety patients undergoing lower limb orthopedic surgery were randomly allocated into three groups (n=30 each): Group R received 15mg hyperbaric ropivacaine 0.75% alone, Group RC received ropivacaine plus 30μg clonidine, and Group RN received ropivacaine plus 0.8mg nalbuphine. Primary outcomes included onset and duration of sensory and motor block. Secondary outcomes comprised duration of analgesia, hemodynamic parameters, and adverse effects. Both adjuvant groups showed significantly faster onset of sensory block (RC: 4.2±0.8min, RN: 4.5±0.9min) compared to control (5.8±1.1min) (p<0.001). Duration of sensory block was prolonged in Group RC (246±28min) and Group RN (218±24min) versus Group R (168±21min) (p<0.001). Motor block duration was longest in Group RC (198±22min), followed by RN (176±19min) and R (142±17min) (p<0.001). Time to first rescue analgesia was significantly extended in RC (386±42min) and RN (342±38min) compared to R (246±31min) (p<0.001). Hypotension incidence was higher in Group RC (33.3%) compared to RN (16.7%) and R (13.3%) (p=0.041). Both clonidine and nalbuphine effectively enhance ropivacaine spinal anesthesia, with clonidine providing superior block characteristics but increased hypotension risk.

Keywords

ClonidineHyperbaric ropivacaineIntrathecal adjuvantsNalbuphineSpinal anesthesiaSubarachnoid block

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How to Cite

Sehgal, A., Jagar, K. D., Gupta, L. K., Sharma, S., Goel, S., Vaid, N., & Madhrey, M. (2025). Comparative Evaluation of Intrathecal Clonidine and Nalbuphine as an Adjuvant to Hyperbaric Ropivacaine in Subarachnoid Block. International Journal of Medical and All Body Health Research, 6(3), 82-88. https://doi.org/10.54660/IJMBHR.2025.6.3.82-88

Sehgal, Ankur, et al. "Comparative Evaluation of Intrathecal Clonidine and Nalbuphine as an Adjuvant to Hyperbaric Ropivacaine in Subarachnoid Block." International Journal of Medical and All Body Health Research, vol. 6, no. 3, 2025, pp. 82-88. https://doi.org/10.54660/IJMBHR.2025.6.3.82-88.

Sehgal, A., Jagar, K. D., Gupta, L. K., Sharma, S., Goel, S., Vaid, N. and Madhrey, M. (2025) 'Comparative Evaluation of Intrathecal Clonidine and Nalbuphine as an Adjuvant to Hyperbaric Ropivacaine in Subarachnoid Block', International Journal of Medical and All Body Health Research, 6(3), pp. 82-88. doi: 10.54660/IJMBHR.2025.6.3.82-88.

Sehgal A, Jagar KD, Gupta LK, Sharma S, Goel S, Vaid N, et al. Comparative Evaluation of Intrathecal Clonidine and Nalbuphine as an Adjuvant to Hyperbaric Ropivacaine in Subarachnoid Block. International Journal of Medical and All Body Health Research. 2025;6(3):82-88. doi:10.54660/IJMBHR.2025.6.3.82-88

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