Comparative study of intrathecal bupivacaine and clonidine combination versus bupivacaine and dexmedetomedine for gynaecological procedures
Journal Title: Medpulse International Journal of Anesthesiology - Year 2017, Vol 2, Issue 1
Abstract
Background: Gynaecological procedures are often done under regional anaesthesia.Various adjuvants are being used with local anesthetics for prolongation of intraoperative and post-operative analgesia. Dexmedetomidine, a highly selective alpha-2adrenergic agonist, has emerged as a valuable adjunct to regional anesthesia and analgesia.The study was aimed to compare the onset, duration of sensory and motor block, hemodynamic effects, post-operative analgesia, and adverse effects of dexmedetomidine and clonidine with bupivacaine for spinal anesthesia. Material and Methods: A total of 50 patients belonging to ASA Grade 1 and 2 undergoing elective gynecological surgery under spinal anesthesia were studied. The patients were allocated in two groups (25 each). Group I bupivacaine + clonidine (B+C) received 17.5 mg of bupivacaine supplemented 45 mcg clonidine and Group II bupivacaine + dexmedetomidine (B+D) received 17.5 mg bupivacaine supplemented 5 mcg dexmedetomidine. The onset time of sensory and motor level, time to reach peak sensory and motor level, hemodynamic changes and side effects were recorded. Results: Mean time of onset of sensory block in Group I and Group II were found to be 3.65±0.68 mins and 2.78±0.20 mins respectively (p>0.05). The onset of motor block in Group I was slightly less than Group II. Five patients in Group I B+C and nine patients from group II B+D had significant bradycardia and hypotension. Nausea and vomiting was reported in one case in group I B+C shivering was reported in 1 case of each group. Discussion: Use of intrathecal dexmedetomidine as an adjuvant to bupivacaine seems to be an attractive alternative to clonidine for long duration gynecological surgical proceduresdue to its profound intrathecal anesthetic and analgesic properties combined with minimal side effects.
Authors and Affiliations
Madhuri Pramod Lonikar, Shubhada Anand Patil, Mohd. Imran Haroon
Keywords
Related Articles
- EP ID EP261614
- DOI -
- Views 165
- Downloads 0
A study of phrenic nerve paralysis after vertical infraclavicular brachial plexus block
Background: Peripheral nerve blocks are gaining widespread popularity for perioperative management because of their distinct advantages over general and central neuraxial anaesthesia. Infraclavicular brachial plexus bloc...
A randomized, prospective, comparative study to evaluate the motor blockade properties of 3ml of 0.5% isobaric levobupivacaine and 3ml of 0.5% isobaric ropivacaine for spinal anaesthesia in patients undergoing elective lower limb orthopaedic surgeries
Background: Levobupivacaine is S (-) enantiomer of bupivacaine. It is somewhat less cardiotoxic than the racemic bupivacaine. It seems to be an attractive alternative to Bupivacaine. Ropivacaine is a long acting regional...
Role of Inj. Dexamethasone for prevention of post operative nausea and vomiting in laparoscopic surgeries
Aims and Objectives: To study the role of inj. Dexamethasone for early and late Post Operative Nausea and Vomiting in laparoscopic surgeries. And also to record side effects of dexamethasone. Study Design: Prospective, r...
A clinical comparative study between bupivacaine with clonidine and bupivacaine alone in paravertebral block for simple breast surgery
Background: Regional anesthesia using paravertebral block, intercostalblock, and epidural anesthesia have been suggestedas an alternative technique in simple breast surgery. Regional techniques reduce postoperative pain...
Randomized controlled study on comparative evaluation of 0.75% ropivacaine with 0.75% ropivacaine with dexmedetomidine in epidural anaesthesia in lower limb orthopaedic surgeries
Background: Regional anesthesia and analgesia has the potential to provide excellent operating conditions and prolongedpost operative pain relief. Epidural blockade is becoming one of the most useful and versatile proced...