Evaluation and comparison of intravenous clonidine and intravenous dexmedetomidine on duration of bupivacaine spinal anesthesia
Journal Title: Indian Journal of Clinical Anaesthesia - Year 2017, Vol 4, Issue 1
Abstract
Context: Alpha-2 agonists improve the block characteristics in regional anesthesia, when added to local anesthetics. Aim: To evaluate and compare efficacy of dexmedetomidine and clonidine, as an intravenous adjuvant to intrathecal bupivacaine. Settings and Design: Prospective, randomized, double-blind placebo-controlled study. Methods and Material: 75 patients of American Society of Anaesthesiologists status I or II, scheduled for orthopaedic lower limb surgery under spinal anaesthesia, were randomly allocated into three groups of 25 each. Patients in group D received dexmedetomidine 1μg/kg; group C received clonidine 2μg/kg and group PL received physiological saline, each premixed to 20 ml intravenously over 20 min, starting 20 min after the subarachnoid block with 15 mg of 0.5% hyperbaric bupivacaine. Duration of sensory and motor blockade, postoperative analgesia, sedation scores and side effects were recorded. Statistical analysis used: Parametric testing done using one-way analysis of variance (ANOVA), intergroup comparison with post-hoc analysis Tukey’s test. Categorical data analyzed using Chi-square test. P< 0.05 was statistically significant. Results: Duration of sensory block was significantly prolonged by dexmedetomidine (231.20+24.84 min) and clonidine (200+23.67 min) than placebo (171+12.25 min) (p<0.001). Duration of motor block was 135.20+12.87 min with placebo, 180.40+24.70 min with clonidine and 205.20+25.56 min with dexmedetomidine (p<0.001). Postoperative analgesia was significantly prolonged by dexmedetomidine (255+23.14 min) than by clonidine (221.40+ 24.30 min) and placebo (202.60+14.08 min) (p<0.001). The mean sedation score was significantly higher in dexmedetomidine group. Conclusion: Single-dose intravenous dexmedetomidine and clonidine given after spinal anaesthesia prolong duration of sensory and motor block and postoperative analgesia.
Authors and Affiliations
Kalyani Nilesh Patil, Kavita Udaykumar Adate, Shalini Pravin Saredesai
Keywords
Related Articles
- EP ID EP311353
- DOI 10.18231/2394-4994.2017.0014
- Views 121
- Downloads 0
Comparison of uterotonic effects of three low dose oxytocin regimens; bolus plus continuous infusion, bolus or continuous infusion during elective caesarean section: A double blind randomized control trial
Background: Oxytocin is considered the drug of choice for managing post-partum hemorrhage resulting from uterine atony, but optimum regimen of oxytocin is yet to be uncovered. Here our primary aim was to compare the uter...
Retrosternal goitre: Anaesthetic implications and management
Large retrosternal goitre is a challenge to the anaesthesiologist and the surgeon We describe the successful anaesthetic management of a 44 year old male patient with extensive retrosternal goitre with severe tracheal co...
A study on postoperative analgesic effects of intra articular ropivacaine and femoral nerve block in unilateral total knee replacement surgery
Introduction: Pain after total knee replacement surgery if not taken care of properly may interfere with early mobilization and recovery process. Infiltrating an anesthetic agent in the joint at the end of surgery is gai...
A randomised comparative study on intraoperative bispectral index monitoring vs. conventional monitoring on awakening time, extubatation time and early postoperative recovery from general anaesthesia using desflurane as inhalational anaesthetic during maintenance of anaesthesia in morbidly obese patients undergoing laparoscopic sleeve gastrectomy surgery
Introduction In India incidence of obesity is in increasing trend Anaesthetising morbidly obese patients is challenge to anaesthesiologist Due to alteration in pharmacokinetics and pharmacodynamics in obese patients drug...
Attenuation of pressor response to laryngoscopy and intubation: Dexmedetomidine Vs. fentanyl premedication
Introduction The pressor response during laryngoscopy and intubation is part of a huge spectrum of stress response results from the increase in sympathetic and sympathoadrenal activity The present study was planned to ob...