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Evaluation of analgesic effects of intrathecal clonidine along with bupivacaine in cesarean section.

Kothari N, Bogra J, Chaudhary AK - Saudi J Anaesth (2011)

Bottom Line: The proportion of adverse events was compared using the chi-square test (χ(2) =57.2410).On adding 50 μg clonidine, we were able to reduce intrathecal dose of bupivacaine for cesarean section to 8 mg.It also significantly prolongs postoperative pain relief.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, CSMMU (erstwhile KGMC), Lucknow, Uttar Pradesh, India.

ABSTRACT

Unlabelled: AIMS AND CONTEXT: The objective of the present study was to evaluate the analgesic and adverse effects of intrathecal clonidine with hyperbaric bupivacaine in spinal anesthesia.

Settings and design: Randomized single blind trial.

Methods: 210 ASA I-II pregnant females undergoing emergency cesarean section were randomized in a single-blind fashion to one of the three groups. In group I (n=70) patients received 12.5 mg of 0.5% hyperbaric bupivacaine intrathecally. In group II (n=70) patients received intrathecal mixture of 0.5% hyperbaric bupivacaine (8 mg) and clonidine 50 μg. In group III (n=70), patients received 0.5% hyperbaric bupivacaine (10 mg) intrathecally along with 50 μg of clonidine.

Statistical analysis used: Groups were compared using one-way ANOVA with the Bonferroni multiple comparison post hoc test. The proportion of adverse events was compared using the chi-square test (χ(2) =57.2410).

Results: On adding 50 μg clonidine, we were able to reduce intrathecal dose of bupivacaine for cesarean section to 8 mg. Patients receiving intrathecal clonidine along with bupivacaine had significantly long lasting analgesia with lower bupivacaine dose [246.21±5.15 min. (group II) vs 146.0±4.55 min (group I), P=0.021; 95% confidence interval: 238.01-257.40, group II and 134.99-157.0 group I].

Conclusions: Addition of intrathecal clonidine causes some sedation in the postoperative period, but it provides adequate analgesia and motor paralysis at lower dose of bupivacaine. It also significantly prolongs postoperative pain relief.

No MeSH data available.


Related in: MedlinePlus

Changes in systolic blood pressure with respect to time, after giving spinal anesthesia
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Figure 0001: Changes in systolic blood pressure with respect to time, after giving spinal anesthesia

Mentions: Incidence of intraoperative visceral pain (judged by patient) was significantly reduced after adding clonidine with lower bupivacaine dose; visceral pain was seen in only three cases in group II, which was managed by i.v. paracetamol infusion (1 g, Perfalgan). No incidence of visceral pain was observed in groups II and I. In our study the maximum fall in systolic blood pressure from baseline was observed at 25 min [Figure 1]. In bupivacaine-clonidine combination groups, fall in systolic blood pressure from baseline increased with increasing bupivacaine dose (gr III>gr II). On comparing hemodynamic stability we found group II was hemodynamically more stable than group I as lower dose of bupivacaine was used. Incidence of hypotension (20% decrease from baseline MAP) increases with higher dose of bupivacaine [Figure 1]. We also observed statistically significant difference in incidence of bradycardia between groups I and II.


Evaluation of analgesic effects of intrathecal clonidine along with bupivacaine in cesarean section.

Kothari N, Bogra J, Chaudhary AK - Saudi J Anaesth (2011)

Changes in systolic blood pressure with respect to time, after giving spinal anesthesia
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3101750&req=5

Figure 0001: Changes in systolic blood pressure with respect to time, after giving spinal anesthesia
Mentions: Incidence of intraoperative visceral pain (judged by patient) was significantly reduced after adding clonidine with lower bupivacaine dose; visceral pain was seen in only three cases in group II, which was managed by i.v. paracetamol infusion (1 g, Perfalgan). No incidence of visceral pain was observed in groups II and I. In our study the maximum fall in systolic blood pressure from baseline was observed at 25 min [Figure 1]. In bupivacaine-clonidine combination groups, fall in systolic blood pressure from baseline increased with increasing bupivacaine dose (gr III>gr II). On comparing hemodynamic stability we found group II was hemodynamically more stable than group I as lower dose of bupivacaine was used. Incidence of hypotension (20% decrease from baseline MAP) increases with higher dose of bupivacaine [Figure 1]. We also observed statistically significant difference in incidence of bradycardia between groups I and II.

Bottom Line: The proportion of adverse events was compared using the chi-square test (χ(2) =57.2410).On adding 50 μg clonidine, we were able to reduce intrathecal dose of bupivacaine for cesarean section to 8 mg.It also significantly prolongs postoperative pain relief.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, CSMMU (erstwhile KGMC), Lucknow, Uttar Pradesh, India.

ABSTRACT

Unlabelled: AIMS AND CONTEXT: The objective of the present study was to evaluate the analgesic and adverse effects of intrathecal clonidine with hyperbaric bupivacaine in spinal anesthesia.

Settings and design: Randomized single blind trial.

Methods: 210 ASA I-II pregnant females undergoing emergency cesarean section were randomized in a single-blind fashion to one of the three groups. In group I (n=70) patients received 12.5 mg of 0.5% hyperbaric bupivacaine intrathecally. In group II (n=70) patients received intrathecal mixture of 0.5% hyperbaric bupivacaine (8 mg) and clonidine 50 μg. In group III (n=70), patients received 0.5% hyperbaric bupivacaine (10 mg) intrathecally along with 50 μg of clonidine.

Statistical analysis used: Groups were compared using one-way ANOVA with the Bonferroni multiple comparison post hoc test. The proportion of adverse events was compared using the chi-square test (χ(2) =57.2410).

Results: On adding 50 μg clonidine, we were able to reduce intrathecal dose of bupivacaine for cesarean section to 8 mg. Patients receiving intrathecal clonidine along with bupivacaine had significantly long lasting analgesia with lower bupivacaine dose [246.21±5.15 min. (group II) vs 146.0±4.55 min (group I), P=0.021; 95% confidence interval: 238.01-257.40, group II and 134.99-157.0 group I].

Conclusions: Addition of intrathecal clonidine causes some sedation in the postoperative period, but it provides adequate analgesia and motor paralysis at lower dose of bupivacaine. It also significantly prolongs postoperative pain relief.

No MeSH data available.


Related in: MedlinePlus