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Analgesic Efficacy of Addition of Clonidine to Bupivacaine in Transversus Abdominis Plane Block for Postoperative Analgesia in Laparoscopic Appendicectomy

Jyotsna Bhosale , Samhita Kalimireddy1 , Jyotsna Bhosale2 , Sarita Swami3

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Indian Journal of Anesthesia and Analgesia 7(5):p 1209-1215, September – October 2020. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.7520.48

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Samhita Kalimireddy, Jyotsna Bhosale, Sarita Swami. Analgesic Efficacy of Addition of Clonidine to Bupivacaine in Transversus Abdominis Plane Block for Postoperative Analgesia in Laparoscopic Appendicectomy. Indian J Anesth Analg. 2020;7(5):1209–1215.
 

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Abstract

Background and Objectives: Transversus abdominis plane block is widely practised peripheral nerve block and has been shown to provide postoperative pain relief following various abdominal surgeries. Proper pain management is essential for optimizing clinical outcomes and early ambulation post operatively. Alpha-2 agonists are mixed with local anesthetic agents to extend the duration of spinal, extradural and peripheral nerve blocks. We compared addition of clonidine as an adjuvant to bupivacaine in transversus abdominis plane block with respect to duration of analgesia and total analgesic requirement in 24 hours. Methods: Sixty ASA I and II patients scheduled for elective or emergency laparoscopic appendicectomy were divided into two equal groups in a randomized double-blinded fashion. Group B received bilateral USG guided TAP block with 15ml of 0.25% bupivacaine (total of 30ml). Group C received bilateral USG guided TAP block with 15ml of 0.25% bupivacaine + clonidine 1mcg/kg (total of 30ml + clonidine 2mcg/kg). Duration of analgesia and total analgesic requirement in 24 hours were studied. Hemodynamic parameters like pulse rate, systolic and diastolic BP and possible side effects were observed. Results: Duration of analgesia in Group B and Group C was 11.18 ± 2.51 hrs and 19.73 ± 2.33 hrs respectively. Total analgesic requirement in 24-hours in Group B and Group C was 2.63 ± 0.67 and 1.20 ± 0.48 respectively. Conclusion: Clonidine as an adjunct to bupivacaine in bilateral USG guided TAP block provides prolonged and sustained pain relief with reduced analgesic requirement and lesser side effects as compared to bupivacaine alone.

 

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Samhita Kalimireddy, Jyotsna Bhosale, Sarita Swami. Analgesic Efficacy of Addition of Clonidine to Bupivacaine in Transversus Abdominis Plane Block for Postoperative Analgesia in Laparoscopic Appendicectomy. Indian J Anesth Analg. 2020;7(5):1209–1215.
 

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.7520.48

Keywords

TAP Block; Clonidine; Bupivacaine; VAS; Postoperative Analgesia

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