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Singh, Vishwadeep
- Effect of Intrathecal and Intravenous Clonidine Given as Adjuvant to Bupivacaine in Spinal Anaesthesia
Authors
1 Department of Anaesthesiology, Sri Ram Murti Smarak Institute of Medical Sciences, Bareilly, IN
2 Department of Anaesthesiology, Sri Ram Murti Smarak Institute of Medical Sciences, Bareilly,, IN
Source
Central Journal of ISA, Vol 2, No 2 (2018), Pagination: 56-61Abstract
Introduction: Clonidine potentiates sensory and motor blockade of epidural and peripheral nerve block. Our aim in this study was to evaluate effect of intrathecal and intravenous clonidine, on spinal anaesthesia.
Materials and Methods: Patients who met the selection criteria were randomly divided into three groups. Group I: Spinal anaesthesia with 0.5% heavy bupivacaine 3ml, Group II: Spinal anaesthesia with 0.5% heavy bupivacaine 3ml + inrathecal clonidine 75 μg, Group III: Spinal anaesthesia with 0.5% heavy bupivacaine 3ml + intravenous clonidine 3 μg/kg.
Statistical Analysis: Computer software SPSS version 20 was used for the statistical analysis of the data. A p value of 0.05 or less was considered as statistically significant.
Observation and Results: The mean time of onset of sensory block in Group I, II and III was 5.32, 4.32 and 4.25 minutes (p < 0.001). Time of onset of motor block was 10.10, 7.12 and 6.84 minutes in Group I, II and III (p < 0.001). The duration of sensory block was 169.75, 291.20 and 293.75 minutes in Group I, II and III (p < 0.001). The duration of motor block was 149.25, 208.80 and 215.63 minutes in Group I, II and III (p < 0.001). The time for demand of analgesia was 137.50, 364.80 and 371.31 minutes in Group I, II and III (p < 0.001). Hypotension was the most common side effect in the three groups.
Conclusion: Clonidine is a good alternative choice as adjuvant to spinal anaesthesia in addition to opioids.
Keywords
Analgesia, Bupivacaine, Clonidine, Motor Block, Spinal Anaesthesia, Sensory Block.Full Text
References
- Corning JL. Spinal anaesthesia and local medication of the cord. NY Med J. 1885; 42:483-5.
- Bier A. Versuche uber Cocainisirung des Ruckenmarkes (Experiments on cocainization of the spinal cord. Dtsche Z Chir.1899; 51:361-9.
- Racle JP, Benkhadra A, Poy JY, et al. Prolongation of isobaric bupivacaine spinal anaesthesia with epinephrine and clonidine for hip surgery in the elderly. Anesth Analg. 1987; 66:442-6.
- Whizar-Lugo V, Irma A, Gomez-Ramirez, Cisneros-corral R, Martinez-Gallegos N. Intravenous dexmedetomodine vs intravenous clonidine to prolong bupivacaine spinal anesthesia. A Double Blind Study. Anestesiaen Mexico. 2007; 19:143-46.
- Niemi L. Effects of intrathecal clonidine on duration of bupivacaine spinal anesthesia, hemodynamics, and postoperative analgesia in patients undergoing knee arthroscopy. Acta Anaesthesiol Scand. 1994; 38:724-8.
- Dobrydnjov I, Axelsson K, Thorn SE, Matthiesen P, Klockhoff H, Holmstorm B, et al. Clonidine combined with small dose bupivacaine during spinal anaesthesia for inguinal herniorrhaphy: A randomised double blinded study. Anesth Analg. 2003; 96:1496-503.
- Sethi BS, Samuel M, Sreevastava D. Efficacy of analgesic effects of low dose intrathecal clonidine as adjuvant to bupivacaine. Indian J Anaesth. 2007; 51:415.
- Grace D, Bunting H, Milligan KR, et al. Postoperative analgesia after coadministration of clonidine and morphine by the intrathecal route in patients undergoing hip replacement. Anesth Analg. 1995; 80:86-91.
- Gecaj-Gashi A, Terziqi H, Pervorfi T, Kryeziu A. Intrathecal clonidine added to small dose bupivacaine prolongs postoperative analgesia in patients undergoing transurethral surgery. Can Urol Assoc J. 2012; 6(1):25-29.
- Shah PN, Pawar D. Use of intravenous clonidine for prolonging spinal anaesthesia. Global Journal of Medical Research: I surgeries and cardiovascular system. 2014; 1(14).
- Rhee K, Kang K, Kim J, Jeon Y. Intravenous clonidine prolongs bupivacaine spinal anesthesia. Acta Anaesthesiol Scand. 2003; 47(8):1001-5.
- Reddy VS, Shaik NA, Donthu B, Sannala VKR, Jangam V. Intravenous dexmedetomidine versus clonidine for prolongation of bupivacaine spinal anesthesia and analgesia: A randomized double blind study. J Anaesthesiol Clin Pharmacol. 2013; 29(3):342-7.
- Reddy SVR, Yaksh TL. Spinal noradrenergic terminal system mediates antinociception. Brain Res. 1980; 189:391-401.
- Erne-Brand F, Jirounek P, Drewe J, et al. Mechanism of antinociceptive action of clonidine in nonmyelinated nerve fibres. Eur J Pharmacol. 1999; 383:1-8.
- Filos KS, Goudas LC, Patroni O, et al. Hemodynamic and analgesic profile after intrathecal clonidine in humans: a dose response study. Anesthesiology. 1994; 81:591-601.