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Indian Journal of Anesthesia and Analgesia

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Comparison of Two Different doses of Clonidine Hydrochloride as an Adjuvant to Epidural Bupivacaine for Postoperative Analgesia

Nitin Kumar, Senior Resident, Department of Anaesthesiology & Critical Care Medicine, VDepartment of Anaesthesiology & Critical Care Medicine, Vardhaman Mahavir Medical College & Safdarjung Hospital, New Delhi, Delhi 110029, India , Prakash Jay1 , Kumar Nitin2 , G.C. Brijesh3 , Prabhu J. Prashanth4 , Raja K.R. Praveen5 , Gupta A.6

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Indian Journal of Anesthesia and Analgesia 5(11):p 1862-1871, November-December 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.51118.14

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Abstract

  Context: The study was planned to assess the comparative efficacy, duration of analgesia block characteristics and hemodynamic or any adverse events on combining clonidine in two different doses with epidural Bupivacaine as adjuvant. Settings and Design: This study was an interventional, prospective, double blind, parallel group, randomised clinical study conducted on patients undergoing elective lower abdominal and lower limb surgeries. Methods and Material: This study was conducted on 80 patients of the American Society of Anesthesiologists (ASA) grade I or II, age 18 to 59 years and included both genders. In Study group A (n =40) 5ml (75µg) of the clonidine hydrochloride­bupivacaine solution added to 10 ml of 0.5% Bupivacaine to make a volume of 15 ml and given via epidural route. Study group B (n =40) 4ml (60µg) of clonidine hydrochloride­bupivacaine solution added to 11 ml of 0.5% Bupivacaine to make a volume of 15 ml and given via epidural route. Our aim was to compare the following factors in two groups – Onset of sensory and motor block, Level of sensory block, Duration of motor blockade and sensory analgesia, hemodynamic changes and adverse events if any. Statistical analysis used: The statistical analysis was done using the sample “t” test and chi­square test. The cleaned and checked data was entered in the computer through software Graph Pad Instat 3.1 and output was assessed. P < 0.05 was considered significant. Results: Onset of anesthesia was shorter in group B as compared to group A. The mean time for onset of sensory block and motor block in group A were 8.17±1.15 and 19.55±1.5 minutes respectively and in group B were 7.42±1.01 and17.17±1.37 minutes respectively and they were statically very highly significant (p < 0.001). The establishment of complete motor blockade was earlier in B group which was statistically highly significant (p < 0.001). There was no significant difference in respiratory depression, systolic and diastolic blood pressure in both the groups (p>0.05). Conclusions: both the doses of clonidine (60µg and 75µg) when administered through the epidural route with 0.5% Bupivacaine provide effective analgesia during intraoperative period. But in postoperative period, 75µg clonidine with 0.5% Bupivacaine provide prolonged analgesia as compared to 60µg clonidine without any significant increase in side effects and change in hemodynamic profile. 

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.51118.14

Keywords

Clonidine; Epidural; Bupivacaine; Postoperative Analgesia; Haemodynamics 

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