A study of intrathecal bupivacaine with fentanyl and intrathecal bupivacaine with clonidine with respect to sedation and intraoperative and postoperative analgesia in patients undergoing lower abdominal and lower limb surgeries
Journal Title: Medpulse International Journal of Anesthesiology - Year 2017, Vol 3, Issue 2
Abstract
Background: Spinal anesthesia is a preferred choice of anesthesia in lower abdominal and lower limb surgeries. Various drugs have been used as adjuvants along with bupivacaine for subarachnoid block, but fentanyl and clonidine are commonly used for prolonging both sensory and motor blockade as well as postoperative analgesia. In present study, we tried to study sedation and analgesic effectiveness of intrathecal clonidine heavy bupivacaine combination with intrathecal fentanyl heavy bupivacaine for lower limb and lower abdominal surgeries. Material and Methods: This prospective, randomised double-blind, controlled study consisted of 90 patients scheduled for lower abdominal and lower limb surgeries. Patients were randomly allocated in 3 equal groups. Group A patients received 0.5% hyperbaric bupivacaine with preservative free normal saline, Group B patients received 0.5% hyperbaric bupivacaine with 0.5µg/kg clonidine and Group C patients received 0.5% hyperbaric bupivacaine with 0.5 µg/kg fentanyl. Assessment of pain was done using Visual Analogue Scale and Sedation was judged by Ramsay Sedation Scale. Results: Mean sedation score in group C (2.20±0.4) was significantly higher than group A (1.93±0.25). There was no significant difference in group B and group C. Duration of analgesia in group B (269.30±12.13) was significantly higher than group A (201.6±11.67) and group C (240.73±9.4). Also it was significantly higher in group C compared to group A. Conclusion: Clonidine and fentanyl seems to be an attractive alternative as an adjuvant to spinal bupivacaine. Clonidine when compared with fentanyl, offers a better additive with bupivacaine owing to earlier onset and prolonged duration of sensory and motor blockade as well as longer duration of analgesia.
Authors and Affiliations
Keshav Gutte, Surekha Shinde, Kalpana Kelkar
Keywords
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- EP ID EP454432
- DOI 10.26611/1015326
- Views 179
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