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Comparative study between epidural morphine and bupivacaine with epidural clonidine and bupivacaine for postoperative pain relief in abdominal surgeries.

Parikh TJ, Divecha V, Dalwadi D - Anesth Essays Res (2015 Jan-Apr)

Bottom Line: Continuous data are analyzed by Student's t-test (paired 't'-test for intragroup variations and unpaired 't'-test for intergroup variations).Chi-square test was used for categorical data.A P ≤ 0.05 was considered to be statistically significant.

View Article: PubMed Central - PubMed

Affiliation: Department of Anaesthesiology, B J Medical College, Civil Hospital, Ahmedabad, Gujarat, India.

ABSTRACT

Background: Many adjuvants are used to increase the efficacy of epidural local anesthetics for postoperative analgesia.

Aims: The aim was to compare the efficacy of epidural morphine (0.1 mg/kg) and clonidine (2 μg/kg) with bupivacaine (0.125%) for postoperative analgesia in abdominal surgeries.

Settings and design: Double-blind retrospective randomized study.

Methodology: All the patients (n = 60) varying from age group belonging to American Society of Anesthesiologists I-II were randomly allocated to receive epidural analgesia Group A - Morphine (0.1 mg/kg). + Bupivacaine (0.125%) (n = 30), Group B - Clonidine (2 μ/kg) + Bupivacaine (0.125%) (n = 30). We monitored vitals and requirement of inhalational gases intra-operatively, pain by visual analogue score (VAS) and vitals postoperatively. We used rescue analgesics (injection diclofenac 1 mg/kg intravenous) when VAS score > 5. Postoperatively, various parameters were monitored for first 2 h at intervals of 30 min and at 4, 8, 12, 16, and 24 hourly intervals after giving 1(st) dose.

Statistical analysis used: Continuous data are analyzed by Student's t-test (paired 't'-test for intragroup variations and unpaired 't'-test for intergroup variations). Chi-square test was used for categorical data. A P ≤ 0.05 was considered to be statistically significant.

Results: Mean duration of analgesia was 8.35 ± 0.42 h in Group A (morphine) and 7.45 ± 0.44 h in Group B (clonidine). This difference was statistically significant (P < 0.001), indicating a prolongation of analgesia in group morphine. There was no need of rescue analgesia in any subjects. Group A patients were hemodynamically stable and required less inhalation agents intra-operatively compared to group B patients.

Conclusions: Epidural morphine plus bupivacaine has a longer duration of analgesia and greater hemodynamic stability as compared to epidural clonidine plus bupivacaine for postoperative analgesia in abdominal surgeries.

No MeSH data available.


Related in: MedlinePlus

Heart rate comparison between two groups
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Figure 1: Heart rate comparison between two groups

Mentions: Preoperative pulse was comparable in both the groups. Within 1 h after epidural dose, Heart rate varied from 63.27 ± 6.23 to 93.10 ± 8.15 in clonidine group and 73.63 ± 4.65–84.03 ± 10.5 in morphine group, postoperatively, there is significant decrease in pulse rate from baseline in both groups, more in clonidine group (P < 0.05). Pulse rate in the clonidine group was significantly increased just before subsequent second dose [Figure 1].


Comparative study between epidural morphine and bupivacaine with epidural clonidine and bupivacaine for postoperative pain relief in abdominal surgeries.

Parikh TJ, Divecha V, Dalwadi D - Anesth Essays Res (2015 Jan-Apr)

Heart rate comparison between two groups
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4383131&req=5

Figure 1: Heart rate comparison between two groups
Mentions: Preoperative pulse was comparable in both the groups. Within 1 h after epidural dose, Heart rate varied from 63.27 ± 6.23 to 93.10 ± 8.15 in clonidine group and 73.63 ± 4.65–84.03 ± 10.5 in morphine group, postoperatively, there is significant decrease in pulse rate from baseline in both groups, more in clonidine group (P < 0.05). Pulse rate in the clonidine group was significantly increased just before subsequent second dose [Figure 1].

Bottom Line: Continuous data are analyzed by Student's t-test (paired 't'-test for intragroup variations and unpaired 't'-test for intergroup variations).Chi-square test was used for categorical data.A P ≤ 0.05 was considered to be statistically significant.

View Article: PubMed Central - PubMed

Affiliation: Department of Anaesthesiology, B J Medical College, Civil Hospital, Ahmedabad, Gujarat, India.

ABSTRACT

Background: Many adjuvants are used to increase the efficacy of epidural local anesthetics for postoperative analgesia.

Aims: The aim was to compare the efficacy of epidural morphine (0.1 mg/kg) and clonidine (2 μg/kg) with bupivacaine (0.125%) for postoperative analgesia in abdominal surgeries.

Settings and design: Double-blind retrospective randomized study.

Methodology: All the patients (n = 60) varying from age group belonging to American Society of Anesthesiologists I-II were randomly allocated to receive epidural analgesia Group A - Morphine (0.1 mg/kg). + Bupivacaine (0.125%) (n = 30), Group B - Clonidine (2 μ/kg) + Bupivacaine (0.125%) (n = 30). We monitored vitals and requirement of inhalational gases intra-operatively, pain by visual analogue score (VAS) and vitals postoperatively. We used rescue analgesics (injection diclofenac 1 mg/kg intravenous) when VAS score > 5. Postoperatively, various parameters were monitored for first 2 h at intervals of 30 min and at 4, 8, 12, 16, and 24 hourly intervals after giving 1(st) dose.

Statistical analysis used: Continuous data are analyzed by Student's t-test (paired 't'-test for intragroup variations and unpaired 't'-test for intergroup variations). Chi-square test was used for categorical data. A P ≤ 0.05 was considered to be statistically significant.

Results: Mean duration of analgesia was 8.35 ± 0.42 h in Group A (morphine) and 7.45 ± 0.44 h in Group B (clonidine). This difference was statistically significant (P < 0.001), indicating a prolongation of analgesia in group morphine. There was no need of rescue analgesia in any subjects. Group A patients were hemodynamically stable and required less inhalation agents intra-operatively compared to group B patients.

Conclusions: Epidural morphine plus bupivacaine has a longer duration of analgesia and greater hemodynamic stability as compared to epidural clonidine plus bupivacaine for postoperative analgesia in abdominal surgeries.

No MeSH data available.


Related in: MedlinePlus