Comparative Study of Post Operative Analgesia with Epidural Clonidine and Epidural Normal Saline Using Combined Spinal Epidural Technique
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2017, Vol 4, Issue 1
Abstract
Epidural anaesthesia/analgesia with adjuvant is the preferred method for intra and postoperative pain relief in lower abdominal and lower limb surgeries but search for ideal adjuvant without any side effect goes on. Alpha (2 ) adrenergic agonists have both analgesic and sedative properties when used as an adjuvant in regional anesthesia. Aim: It is a comparative study of post operative analgesia with epidural Clonidine and epidural normal saline in patients undergoing lower abdominal and lower limb surgeries using combined spinal epidural technique. Materials and Methods: The present study was undertaken during the period of May 2015 to October 2016. 100 patients posted for elective major lower abdominal and lower limb surgeries were selected and allocated randomly into two groups. Each group has 50 patients. Group 1:Patients received intrathecal 0.5% Hyperbaric Bupivacaine + epidural Clonidine 1µg/kg or 50µg whichever is lower, diluted to 10ml with normal saline. Group 2: Patients received intrathecal 0.5% Hyperbaric Bupivacaine + epidural 10ml normal saline. Quality of analgesia, duration of analgesia and duration of motor blockade between the two groups were compared. Patient vitals like pulse rate, blood pressure, respiratory rate, SPO2 and ECG were monitored during the study. During the study patients were observed for the side effects like nausea, vomiting, hypotension, bradycardia and dryness of mouth. Results: In present study majority of patients were in the age group between 3150 yrs in both the groups and most of them weigh between 6170 kgs. Total abdominal hysterectomy cases were majority cases observed in both groups. Quality of analgesia is excellent in both the groups and none of the patients complained of severe pain. Mild pain was observed in most of the cases in both the groups. The average time taken for 2 segment regression is more in Clonidine group compared to control group. The total duration of analgesia is more in Clonidine group compared to control group. The time taken for 1st movement i.e. beginning of motor recovery is more in Clonidine group compared to control group. Mean pulse rate, systolic BP and diastolic BP changes are statistically significant in Group 1. Complications observed in Group 1 were nausea & vomiting in 7 patients, hypotension in 7 patients, bradycardia in 1 patient, sedation in 1 patient, dry mouth in 2 patients. Hypoxia and bleeding were not reported. Conclusion: Quality of analgesia is excellent in patients receiving Clonidine when compared to placebo group. Total duration of analgesia and motor blockade is significantly prolonged in Clonidine group compared to placebo group. Minimal side effects like mild hypotension, mild sedation and dryness of mouth were seen in Clonidine group which does not require any active intervention.
Authors and Affiliations
Kamalakar Karampudi
Keywords
Related Articles
- EP ID EP462966
- DOI 10.21088/ijaa.2349.8471.4117.19
- Views 107
- Downloads 0
The Efficacy of Clonidine Added to Bupivacaine as Compared to Bupivacaine Alone Used in Supraclavicular Brachial Plexus Block
Introduction: Supraclavicular brachial plexus block provides anaesthesia of the entire upper extremity in the most consistent and time-efficient manner. The present study was undertaken to evaluate the time of onset, dur...
Observational Study to Compare Dexmedetomidine and Dexamethasone as an Adjuvant to Ropivacaine 0.2% in Potentiation of Post Operative Analgesia in Caudal Block
Introduction: Caudal block is commonly performed in paediatric anaesthesia for post-operative analgesia using various adjuvants. Aim of Study: To compare efficacy and safety of dexmedetomidine and dexamethasone in view...
Sedation with Dexmedtomidine or General Anaestesia in Combination with Regional Anaesthesia in Mastoid Surgeries: A Comparitive Study
Mastoid surgery can be performed under general anaesthesia (GA) or sedation both combined with regional anaesthesia ((RA). There are very few studies comparing both the techniques. Dexmedetomidine is the sedative agent o...
A Retrospective Study of Serial Inspection of ACLS Ambulances in a Tertiary Care Facility
Aim: To maximize availability of Ambulance equipment before dispatch. Design: Retrospective observational study. Material and Methods: A team of doctors, nurses and paramedics of our tertiary care central government hosp...
Effects of types of Anesthesthesia on Neurobehavioral Response and Apgar score in Neonates Delivered with Cesarean Section at CMCH Bhopal
Context: As the Frequency of cesarean section birth continuous to steadily rises worldwide the type of anaesthesia provided has gained importance. Though the anaesthesia has become very safe over the years some studies s...