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Epidural 0.125% levobupivacaine with dexmedetomidine Versus Clonidine for Total Abdominal Hysterectomies: A Prospective Double Blind Randomized Trial

Shivaramu BT , Sarvesh B1 , Shivaramu BT2

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Indian Journal of Anesthesia and Analgesia 6(3):p 1012-1017, May-June 2019. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6319.45

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Sarvesh B, Shivaramu BT. Epidural 0.125% levobupivacaine with dexmedetomidine Versus Clonidine for Total Abdominal Hysterectomies: A Prospective Double Blind Randomized Trial. Indian J Anesth Analg. 2019;6(3):1012-17.

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Received : N/A         Accepted : N/A          Published : N/A

Abstract

Context: Role of anesthesia for total abdominal hysterectomies is concerned with relieving pain during both intraoperative and the postoperative period. Several adjuvants are used to enhance the quality and duration of epidural anesthesia. Aims: We compared clonidine and dexmedetomidine as additives to levobupivacaine for epidural analgesia with emphasis on onset and duration of sensory block, duration of analgesia, and adverse effects. Settings and design: It is a randomized, double blind and prospective study conducted in tertiary care center. Subject and Methods: Sixty patients of American Society of Anesthesiologists (ASA) physical status Classes I and II who underwent total abdominal hysterectomies were randomly allocated into two equal groups. Group LC received 10 ml of 0.125% levobupivacaine + 1 µg.kg-1 of clonidine and Group LD received 10 ml of 0.125% levobupivacaine + 1 µg.kg-1 of dexmedetomidine through the epidural catheter. We evaluated onset of analgesia, time of peak effect, duration of analgesia, cardiorespiratory vitals, adverse effects, and need of rescue analgesics. Statistical analysis: Student’s t-test and chi-square test. Results: Group LD demonstrated early onset, fast peak effect, prolonged postoperative analgesia, and stable cardiorespiratory vitals when compared with Group LC. There was a statistically significant reduction in analgesic requirement in group LD as compared to group LC. There were no major adverse effects in either group. Conclusion: As compared to clonidine, dexmedetomidine is a better neuraxial adjuvant to levobupivacaine, since it provides early onset, prolonged postoperative analgesia and stable cardiorespiratory vital parameters, without increasing adverse effects.

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Sarvesh B, Shivaramu BT. Epidural 0.125% levobupivacaine with dexmedetomidine Versus Clonidine for Total Abdominal Hysterectomies: A Prospective Double Blind Randomized Trial. Indian J Anesth Analg. 2019;6(3):1012-17.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6319.45

Keywords

Clonidine; Dexmedetomidine; Epidural analgesia; Levobupivacaine; Total abdominal hysterectomy

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