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Ultrasound Guided Caudal Epidural: A Comparative Study of Ropivacaine Clonidine versus Ropivacaine Dex Medetomidine for Perioperative Analgesia in Spine Surgery

Saraswathi Nagappa , Saraswathi Nagappa1 , Sandhya Kalappa2 , Raghavendra Biligiri Sridhara3

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Indian Journal of Anesthesia and Analgesia 7(5):p 1131-1137, September – October 2020. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.7520.38

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1,3Assistant Professor, 2Professor, Department of Anesthesia, Bangalore Medical College and Research
Institute and Superspeciality Hospital, Bangalore, Karnataka 560002, India.
 

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

Abstract

Background: Caudal epidural is a proven technique for providing analgesia for lower spinal surgeries. Prolonged pain relief with no motor blockade is desired for early mobilization. Now, with ultrasound, we can visualize the caudal space and can see both the needle position and the injection. This has made the technique much more reliable. Aim: To compare the analgesic and sedative effects Clonidine and dexemedetomidine a selective α2-agonist drugs when used caudal epidurally as an adjuvant to ropivacaine and also to evaluate the feasibility of ultrasound guided caudal block in patients undergoing lumbar spine surgery. Settings and Design: A Comparative, Prospective randomized, controlled two group’s clinical study of 60 adults undergoing lumbosacral surgeries. Materials and Methods: 60 patients were allocated into any one of two groups of 30 patients each, by means of computer-generated randomization: Group RD: Patients receiving caudal block with injected Ropivacaine 0.2% 20 ml+1μg/kg of injdexmedetomidine. Group RC: Patients receiving Ropivacaine 0.2% 20 ml + 2μg/kg clonidine. Statistical Methods: Chi-square/ Fisher Exact test has been used to find the significance of study parameters on categorical scale between two or more groups, Non-parametric setting for Qualitative data analysis. Fisher exact test used when cell samples are very small. Results: The duration of postoperative analgesia was more in RD GROUP compared Patients in RC GROUP, which is statistically significant P=0.005**. Significant lower mean VAS score at 480min [P < 0.001] and 720 min [P 0.010] in RD group compared to RC group with minimal sedation score and hemodynamic disturbances. Conclusion: Dexmedetomidine is a better neuraxial adjuvant to ropivacaine when compared to clonidine for providing prolonged post-operative analgesia with lower pain score and stable cardiorespiratory parameters.


 

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Cite this article

1,3Assistant Professor, 2Professor, Department of Anesthesia, Bangalore Medical College and Research
Institute and Superspeciality Hospital, Bangalore, Karnataka 560002, India.
 

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.7520.38

Keywords

Analgesia; Caudal Epidural; Ultrasound.

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