Evaluation of Intrathecal Bupivacaine-Clonidine Combination in Lower Abdominal Surgeries: A Double Blind Randomized Control Study
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2015, Vol 3, Issue 1
Abstract
Postoperative pain treatment is unsatisfactory, especially after intermediate and major surgical procedures. Addition of adjuvant drugs to intrathecal local anesthetics improves quality and duration of spinal blockade prolonging postoperative analgesia. The present study was undertaken to assess the efficacy of 150 µg of intrathecal Clonidine added to Bupivacaine on postoperative pain and its side effects in lower abdominal surgeries. Double blind randomized controlled study was conducted on 65 adult patients. Group Control received 3ml Bupivacaine and 1ml normal saline intrathecally, whereas Clonidine (study) Group received 3 ml Bupivacaine and 1ml (150mcg) Clonidine intrathecally. 3 patients were excluded and data from 62 patients was collected and statistically analyzed. Assessment of post operative pain was made on basis of visual analog score (VAS) where 0 cm = “no pain’’ and 10 cm = ’’worst pain imaginable”. Nausea was assessed using 4 point verbal scale. Episodes of vomiting were noted. Onset of sensory block was rapid in Group Clonidine (78 ±1.74) vs Group Control (108 ± 1.54) seconds with p<0.001. Motor block was also rapid in Group Clonidine (104 ±3.83) vs Group Control (127 ±2.72) seconds. Regression of block was also slower in Group Clonidine (357 ± 11.2) vs Group Control (176 ± 8.85) minutes. First request for analgesia was late in Group Clonidine (294 ± 10.0) vs Group Control (169 ± 8.52) minutes. VAS (rest) and VAS (movement) scores from T0.5hr to T24hr were less in Group Clonidine. In conclusion intrathecal Clonidine 150µg added to Bupivacaine fasten onset and prolongs duration of sensory and motor block, decreases the rescue analgesic requirement and improves pain score in lower abdominal surgeries.
Authors and Affiliations
Upinder Kaur, Johnpal Singh Sidhu, Shobha Aggarwal
Keywords
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