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Comparitive Study of Epidural Fentanyl and Bupivacaine with Epidural Clonidine and Bupivacaine for Postoperative Pain Relief in Lower Abdominal and Lower Limb Surgeries: RCT

M Sathyasuba , S Selvamani1 , M Sathyasuba2 , Dipro Dey3

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Indian Journal of Anesthesia and Analgesia 7(6):p 1323-1330, November-December 2020. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.7620.66

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S Selvamani, M Sathyasuba, Dipro Dey, et al. Comparitive Study of Epidural Fentanyl and Bupivacaine with Epidural Clonidine and Bupivacaine for Postoperative Pain Relief in Lower Abdominal and Lower Limb Surgeries: RCT. Indian J Anesth Analg. 2020;7(6):1323–1330.

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Abstract

Postoperative pain and discomfort are the major concerns in all patients undergoing any surgery. Delay of discharge is mainly due postoperative pain. So, postoperative pain relief becomes very important. Epidural anal gesiaisone of many recent evidence-base dregimens for postoperative pain relief after surgeries particularly surgeries of abdomen. The objective of this study is to compare the efficacy, onset and duration of epidural analgesia of Bupivacaine - Clonidinecombination Vs. Bupivacaine-Fentanyl combination for post-operative analgesia in lower abdominal and lower limb surgeries. Materials and Methods: 50 patients belonging to ASA 1 and 2 were assigned into two groups (25 each). Group F received epidural Fentanyl with 0. 25% Bupivacaine and Group C received epidural Clonidine with 0.25% Bupivacaine. Results: With regard to anxiolysis, increased sedative property with easy arousal, longer and better quality analgesia and patient comfort, epidural clonidine and Bupivacaine combination was found to be superior to epidural Fentanyl and Bupivacaine. Various parameters like HR, Blood pressure (both systolic and diastolic), SPo2, Visual Analogue Scale (VAS) and Ram say Sedation Score (RSS) were observed for 24 hours post operatively. It was follow edup at 15 minutes, 30 min, 120 min, 240 min, 360 min, 480 min, 600 min, 720 min, 840 min, 960 min, 1080 min, 1200 min, 1320 min and 1440 min. Incidencesof side effects were also noted. Conclusion: Clonidine has proved to be very efficient compared to Fentanyl in postoperative analgesia.

 

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S Selvamani, M Sathyasuba, Dipro Dey, et al. Comparitive Study of Epidural Fentanyl and Bupivacaine with Epidural Clonidine and Bupivacaine for Postoperative Pain Relief in Lower Abdominal and Lower Limb Surgeries: RCT. Indian J Anesth Analg. 2020;7(6):1323–1330.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.7620.66

Keywords

Epidural; Postoperative; Pain; Clonidine; Fentanyl; Analgesia.

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