A Comparative evaluation of effects of Clonidine and Dexmedetomidine when used as an adjuvant to epidural Bupivacaine in lower abdominal and lower limb surgeries.
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2018, Vol 3, Issue 2
Abstract
Background: Epidural anaesthesia is one ofthe most common regional anaestheti techniques used for lower abdominal and lower limb surgeries. Epidural anaesthesia provides effective surgical anaesthesia and can alsoachieve the extended duration of surgical needs, provides prolonged postoperative analgesia, lowers the incidence of hemodynamic changes. The quality and duration of analgesia is improved when a local anaesthetic is combined with alpha-2 adrenergic agonist as neuraxial adjuvants.Aim: The aim of our study is to compare the effect of Clonidine and Dexmedetomidine when used as an adjuvant to epidural Bupivacaine in lower abdominal and lower limb surgeries.Materials and Methods: A prospective randomized double blinded study was conducted in 60 patients of either sex between the ages of 20 and 60 years of (American Society of Anaesthesiologists) ASA I/II grade who underwent lower abdominal and lower limb surgeries. The patients were randomly allocated into two groups; Bupivacaine(0.50%) + Clonidine (C) and Bupivacaine(0.50) + Dexmedetomidine (D) and comprising of 30 patients each.Group C received 15 ml of Bupivacaine (0.50%) with 75 μg Clonidine and group D received 15 ml of Bupivacaine (0.50%) with Dexmedetomidine 50 μg epidurally. Onset of sensory analgesia using bilateral pin-prick method, onset of motor blockade using Bromage scale, time to two dermatome regression of sensory level, time to first demand for analgesia, intra operative hemodynamic parameters and complications were observed. Statistical analysis was done by chi-square test for qualitative data and unpaired student t-test for quantitative data using statistical package for social science (SPSS) version 19 for windows and value of P < 0.05 was considered significant and P < 0.001 as highly significant. Results: The demographic profile and cardio-respiratory parameters were comparable and statistically non-significant in both the groups. The side effect profile was also comparable with a little higher incidence of nausea and dry mouth in both the groups which was again a non-significant entity (P > 0.05) . Dexmedetomidine groupD had rapid onset of sensory and motor blockade (p<0.05), prolonged duration of sensory and motor block (p<0.05) and postoperative analgesia (p<0.05). Conclusion: Dexmedetomidine is a better neuraxial adjuvant to epidural Bupivacaine compared to clonidine for providing early onset and long duration of sensory analgesia and motor blockade, longer post-operative analgesia.
Authors and Affiliations
Dr. Arjun Prasad
Keywords
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