Comparative study of epidural clonidine versus dexmedetomidine as an adjuvant to bupivacaine for post-operative analgesia in infra umbilical surgeries under combined spinal epidural anaesthesia
Journal Title: Medpulse International Journal of Anesthesiology - Year 2019, Vol 9, Issue 3
Abstract
Background: Postoperative pain is an acute pain which starts with surgical trauma and ends with tissue healing. Clonidine is an alpha-2 receptor agonist. Dexmedetomidine is an super selective alpha–2 agonist made up of medetomidine’s dextrogyrous enatiomer. They produces analgesia with haemodynamic changes and minimum side effects. Methods: A clinical study of 70 cases of ASA grade 1 and2 between the age group 25-65yrs undergoing abdominal, obstetrical, gynaecological and orthopaedic surgeries under epidural anaesthesia. At the end of surgery patients were allocated to receive either of (Group – C) Clonidine 2 g /kg with 5 ml of Normal saline. (No = 35) or (Group – D) Dexmeditomidine 1g /kg with 5 ml of Normal saline. (No = 35). Cardio-respiratory effects like Pulse rate, blood pressure, respiratory rate and side effects like nausea, vomiting, pruritus, hypotension, sedation, respiratory depress ion were studied. Continuous data was analyzed by student's “t”-test and categorical data by Chi-square test and possible significance has been determined considering it statistically significant if the P value < 0.05. Results: The duration of analgesia in group -D (440.57 + 45.89 (SD) min)was significantly more when compared to group -C (325.71+ 48.89 (SD) min).In comparison of Group C and Group D, by using the unpaired student t test, highly significant difference in VAS was seen from 2.5 hours till 6hrs in between the groups. In addition Group D patients did not experience pain till 7th and 8th hour but Group C patients experienced pain at the end of 6 hours itself. Highly significant difference in sedation score was seen from 0 min till 6hrs in between the groups. In addition sedation was prolonged in Group D patients till 7th to 8th hours, but in Group C the sedation was persisting up to 4 hours. Conclusion: It was concluded that epidural dexmedetomidine provides an excellent and prolonged duration of analgesia when compared to epidural clonidine. Longer duration of analgesia along with good sedation was also seen when compared with clonidine group
Authors and Affiliations
M Dhakshinamoorthy, Vishnu Priya S
Keywords
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- EP ID EP521173
- DOI 10.26611/1015935
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