Combined Spinal Epidural Anaesthesia versus Spinal Anaesthesia with Clonidine for Hip Surgeries: A Randomized Comparative Study
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2017, Vol 4, Issue 4
Abstract
Background: Surgeries for hip fracture are often time consuming. Both THR and Bipolar surgeries are usually performed under spinal anaesthesia or combined spinal epidural anaesthesia. These surgeries are often accompanied by several perioperative morbidities like blood loss, post operative pain, nausea, vomiting, headache and post operative urinary retention. Aim: Aim of our study was to assess the intraoperative hemodynamic stability, blood loss, intra and postoperative analgesic requirement and intra and postoperative complications in the study groups. Materials and Methods: This study was conducted in tertiary care government hospital during the period of 2014-2016. In this prospective study after ethical committee approval, 60 patients being operated for elective hip surgeries were selected and randomly divided in two groups as Group A and Group B, 30 patients in each. All the patients were thoroughly examined, investigated and optimized for surgery. Group A Received combined spinal epidural anaesthesia. Spinal anaesthesia was given with Inj. Bupivacaine 0.5% (H) 3.5 cc+0.4 cc Normal Saline. Epidural top up was given to prolong duration of surgical anaesthesia with Inj. Bupivacaine 0.5% 4cc and for post operative analgesia with Inj. Bupivacaine 0.125% 8cc. Group B Received spinal anaesthesia with Inj. Bupivacaine 0.5%(H) 3.5cc+Inj. Clonidine 60µg. Results: In our study, Group B showed statistically significant fall in the pulse rate and blood pressure as compared to Group A (P < 0.05 statistically significant but clinically acceptable). The mean blood loss was found to be 586.6±58.6 ml in Group A while in Group B it was 495±49.7 ml( difference statistically significant.). Group A had post-operative analgesia 185±110.9 mins and in Group B it was 399.9±103.8 mins. (statistically significant). The incidence of both intraoperative and postoperative complications in both the study groups was statistically not significant. Conclusion: The results of this prospective, randomized comparative study demonstrated that addition of clonidine to spinal anaesthesia provides hypotensive anesthesia with acceptable hemodynamic parameters, with reduced blood loss, profound and prolonged postoperative pain relief. We conclude that the “spinal anaesthesia with clonidine” is a beneficial alternative for elective hip surgeries as compared to “combined spinal epidural anaesthesia”.
Authors and Affiliations
Pushpa Agrawal
Keywords
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- EP ID EP472178
- DOI 10.21088/ijaa.2349.8471.4417.47
- Views 103
- Downloads 0
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