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Response to low-dose intrathecal clonidine in septuagenarians undergoing sub-umbilical surgeries: A study.

Sen J, Sen B - Saudi J Anaesth (2015 Apr-Jun)

Bottom Line: Duration of motor blockade was longer in the clonidine group (221.4 ± 35.92 min) compared with the control group (112.3 ± 12.45 min).Mean arterial pressure (clonidine 77.67 ± 6.47 vs. control 93.87 ± 3.03, P = 0.0002) and heart rate (clonidine 65.2 ± 5.20 vs. control 77.4 ± 6.06, P = 0.003) were significantly lower (P < 0.05) in the clonidine group compared with the control group from 20 mins after the block to the end of 3 h.We conclude that addition of clonidine in the dose of 7.5 μg to bupivacaine significantly increases the duration of spinal analgesia with clinically insignificant influence on hemodynamic parameters.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesia, Goldfield Institute of Medical Sciences and Research, Ballabgargh, Faridabad, India.

ABSTRACT

Unlabelled: Clonidine, an alpha-2-adrenergic agonist, may have a clinically relevant analgesic action but also a hypotensive action, when administered spinally.

Aim: To evaluate the analgesic and circulatory effects of low-dose intrathecal clonidine co-administered with hyperbaric bupivacaine in septuagenarian patients undergoing sub-umbilical surgeries.

Materials and methods: A total of 20 patients within the age group of 70-80 years of either sex, enrolled in this study, were randomly divided into groups of 10 each. Group I received clonidine 7.5 μg as an adjuvant to 15 mg of hyperbaric bupivacaine and Group II (control group) received 15 mg of bupivacaine with saline to make volume in the two solutions equal.

Result: The level of subarachnoid block was comparable in the two groups. Duration of motor blockade was longer in the clonidine group (221.4 ± 35.92 min) compared with the control group (112.3 ± 12.45 min). Request for 1(st) dose of analgesic was earlier in the control group (135.5 ± 28.52 min) than the clonidine group (295 ± 18.85 min). Mean arterial pressure (clonidine 77.67 ± 6.47 vs. control 93.87 ± 3.03, P = 0.0002) and heart rate (clonidine 65.2 ± 5.20 vs. control 77.4 ± 6.06, P = 0.003) were significantly lower (P < 0.05) in the clonidine group compared with the control group from 20 mins after the block to the end of 3 h. In the clonidine group, 3 patients had postoperative headache, 4 had intra-operative shivering. 2 patients in the clonidine group also developed hypotension and 1 bradycardia and 1 of them developed bradyapnea along with acute hypotension 5 min after shifting to the postoperative ward and later recovered on resuscitation. In the control group 2 patients had bradycardia, 6 had intra-operative shivering and 3 had postoperative headache.

Conclusion: We conclude that addition of clonidine in the dose of 7.5 μg to bupivacaine significantly increases the duration of spinal analgesia with clinically insignificant influence on hemodynamic parameters.

No MeSH data available.


Related in: MedlinePlus

Peroperative complications in the clonidine group and control group
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Figure 3: Peroperative complications in the clonidine group and control group

Mentions: The first request for supplemental analgesia (VAS scores at >2-3) on regression of sensory block was longer in the clonidine group than in the control group (295 ± 18.85 min vs. 135.5 ± 28.52 min). During the surgical procedures in the control group, incidence of hypotension was nil, 2 had bradycardia, 6 had postoperative shivering and 3 had headache in the postoperative period. In the clonidine group 2 patients had hypotension, 1 had bradycardia, 4 had shivering and 3 had post-operative headache [Figure 3]. 1 patient of hypotension and bradycardia suffered a marked fall in blood pressure and bradyapnea in the postoperative room 5 min after discharge from the operation theater and required emergency resuscitation, later recovered.


Response to low-dose intrathecal clonidine in septuagenarians undergoing sub-umbilical surgeries: A study.

Sen J, Sen B - Saudi J Anaesth (2015 Apr-Jun)

Peroperative complications in the clonidine group and control group
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4374218&req=5

Figure 3: Peroperative complications in the clonidine group and control group
Mentions: The first request for supplemental analgesia (VAS scores at >2-3) on regression of sensory block was longer in the clonidine group than in the control group (295 ± 18.85 min vs. 135.5 ± 28.52 min). During the surgical procedures in the control group, incidence of hypotension was nil, 2 had bradycardia, 6 had postoperative shivering and 3 had headache in the postoperative period. In the clonidine group 2 patients had hypotension, 1 had bradycardia, 4 had shivering and 3 had post-operative headache [Figure 3]. 1 patient of hypotension and bradycardia suffered a marked fall in blood pressure and bradyapnea in the postoperative room 5 min after discharge from the operation theater and required emergency resuscitation, later recovered.

Bottom Line: Duration of motor blockade was longer in the clonidine group (221.4 ± 35.92 min) compared with the control group (112.3 ± 12.45 min).Mean arterial pressure (clonidine 77.67 ± 6.47 vs. control 93.87 ± 3.03, P = 0.0002) and heart rate (clonidine 65.2 ± 5.20 vs. control 77.4 ± 6.06, P = 0.003) were significantly lower (P < 0.05) in the clonidine group compared with the control group from 20 mins after the block to the end of 3 h.We conclude that addition of clonidine in the dose of 7.5 μg to bupivacaine significantly increases the duration of spinal analgesia with clinically insignificant influence on hemodynamic parameters.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesia, Goldfield Institute of Medical Sciences and Research, Ballabgargh, Faridabad, India.

ABSTRACT

Unlabelled: Clonidine, an alpha-2-adrenergic agonist, may have a clinically relevant analgesic action but also a hypotensive action, when administered spinally.

Aim: To evaluate the analgesic and circulatory effects of low-dose intrathecal clonidine co-administered with hyperbaric bupivacaine in septuagenarian patients undergoing sub-umbilical surgeries.

Materials and methods: A total of 20 patients within the age group of 70-80 years of either sex, enrolled in this study, were randomly divided into groups of 10 each. Group I received clonidine 7.5 μg as an adjuvant to 15 mg of hyperbaric bupivacaine and Group II (control group) received 15 mg of bupivacaine with saline to make volume in the two solutions equal.

Result: The level of subarachnoid block was comparable in the two groups. Duration of motor blockade was longer in the clonidine group (221.4 ± 35.92 min) compared with the control group (112.3 ± 12.45 min). Request for 1(st) dose of analgesic was earlier in the control group (135.5 ± 28.52 min) than the clonidine group (295 ± 18.85 min). Mean arterial pressure (clonidine 77.67 ± 6.47 vs. control 93.87 ± 3.03, P = 0.0002) and heart rate (clonidine 65.2 ± 5.20 vs. control 77.4 ± 6.06, P = 0.003) were significantly lower (P < 0.05) in the clonidine group compared with the control group from 20 mins after the block to the end of 3 h. In the clonidine group, 3 patients had postoperative headache, 4 had intra-operative shivering. 2 patients in the clonidine group also developed hypotension and 1 bradycardia and 1 of them developed bradyapnea along with acute hypotension 5 min after shifting to the postoperative ward and later recovered on resuscitation. In the control group 2 patients had bradycardia, 6 had intra-operative shivering and 3 had postoperative headache.

Conclusion: We conclude that addition of clonidine in the dose of 7.5 μg to bupivacaine significantly increases the duration of spinal analgesia with clinically insignificant influence on hemodynamic parameters.

No MeSH data available.


Related in: MedlinePlus