The hemodynamic effects of Combined Epinephrine and Clonidine added to intrathecal Bupivacaine in cesarean section

Objective :To compare the hemodynamic effects of combined intrathecal Clonidine and Epinephrin as an additive to bupivacaine in patients undergoing cesarean section . Methods:Following Ethics Committee approval and informed patients consent, Ninety patients 18-40 yr old ASA physical status I or II, scheduled for cesarean section under spinal anesthesia, were studied in a prospective, double-blinded, randomized way. The patients were randomly allocated to one of three groups. The Clonidine group (groupC) received bupivacaine 10mg combined with 75 microgram clonidine preservative free ,the Epinephrin-Clonidin group (group E-C) received bupivacaine 10mg combined with 35 microgram Clonidin and 200 microgram Epinephrin, and the placebo group (group P) received bupivacaine 10mg combined with 0.5ml distilled water intrathecally .Intraoperative changes in hemodynamics variables [Mean Blood pressuer(MBP) and Heart Rate( HR)], Sensory block onset time, maximum sensory level , onset of motor block, duration of blockade, the incidence of hypotension, ephedrine requirements, bradycardia , neonate's APGAR 1 & 5 minute were recorded. MBP was measured and monitored by automated non-invasive blood pressure in arm and HR was recorded by Electrocardiogram(ECG).