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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

Time for onset of sensory block
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Figure 0003: Time for onset of sensory block

Mentions: Recent trends of obstetric anesthesia show increased popularity of regional anesthesia among obstetric anesthetists. General anesthesia in the cesarean section is associated with higher mortality rate in comparison to regional anesthesia. Regional anesthesia is also having its own demerits. Deaths in regional anesthesia are primarily related to excessively high regional blocks and toxicity of local anesthetics. Reduction in doses and improvement in the technique to avoid higher block levels and heightened awareness of toxicity of local anesthetics have contributed to reduction of complications related to regionalanesthesia.[9] On comparing progression of sensory block to T6 dermatome; in our study we found the mean time duration of 6.8 min in group II and minimum time of 5.50 min in group I [Figure 3].


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

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

Time for onset of sensory block
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 0003: Time for onset of sensory block
Mentions: Recent trends of obstetric anesthesia show increased popularity of regional anesthesia among obstetric anesthetists. General anesthesia in the cesarean section is associated with higher mortality rate in comparison to regional anesthesia. Regional anesthesia is also having its own demerits. Deaths in regional anesthesia are primarily related to excessively high regional blocks and toxicity of local anesthetics. Reduction in doses and improvement in the technique to avoid higher block levels and heightened awareness of toxicity of local anesthetics have contributed to reduction of complications related to regionalanesthesia.[9] On comparing progression of sensory block to T6 dermatome; in our study we found the mean time duration of 6.8 min in group II and minimum time of 5.50 min in group I [Figure 3].

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