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Comparison of clonidine and dexmedetomidine as adjuncts to intravenous regional anaesthesia.

Sardesai SP, Patil KN, Sarkar A - Indian J Anaesth (2015)

Bottom Line: Sensorimotor block onset was significantly faster and recovery delayed with dexmedetomidine as compared to clonidine.Dexmedetomidine significantly facilitates onset, prolongs recovery of sensory as well as motor block and also prolongs duration of analgesia as compared to clonidine.   Both decrease tourniquet pain satisfactorily and have comparable intra-operative fentanyl requirement .Patient satisfaction is better with dexmedetomidine.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Srimati Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India.

ABSTRACT

Background and aims: Intravenous regional anaesthesia (IVRA) provides reliable and rapid analgesia with good muscular relaxation of the extremity distal to the tourniquet, but tourniquet pain and absence of post-operative analgesia are major drawbacks. α2 agonists, clonidine and dexmedetomidine are known to potentiate peripheral nerve blocks. The aim of this study was to compare clonidine and dexmedetomidine as adjuvants to IVRA with respect to block characteristics, tourniquet pain and post-operative analgesia.

Methods: A prospective, randomised, double-blind study was conducted on 60 adult patients of American Society of Anesthesiologists physical status grades I and II, in two groups of 30 each, to receive either clonidine 1 μg/kg or dexmedetomidine 1 μg/kg added to 40 ml 0.5% preservative-free lignocaine. Independent samples t-test was used for analysing demographic data, haemodynamic data and block characteristics and Mann-Whitney U-test for skewed data.

Results: Sensorimotor block onset was significantly faster and recovery delayed with dexmedetomidine as compared to clonidine. Intra-operative visual analogue scale (VAS) at 10 min, 15 min and 40 min and post-operative VAS at 30 min and 2 h were significantly higher with clonidine. Fentanyl consumption and sedation were comparable. Duration of analgesia was significantly longer with dexmedetomidine. Haemodynamic parameters were comparable.

Conclusions: Dexmedetomidine significantly facilitates onset, prolongs recovery of sensory as well as motor block and also prolongs duration of analgesia as compared to clonidine.   Both decrease tourniquet pain satisfactorily and have comparable intra-operative fentanyl requirement . Patient satisfaction is better with dexmedetomidine.

No MeSH data available.


Related in: MedlinePlus

Comparison of recovery of sensory and motor block
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Figure 2: Comparison of recovery of sensory and motor block

Mentions: There was a significant difference in both groups with respect to mean onset and recovery of sensory and motor block. Sensory block onset and recovery were 6.18 ± 1.07 min and 5.1 ± 1.12 min, respectively in Group C and 4.28 ± 1.23 min and 7.3 ± 1.49 min, respectively in Group D (P < 0.001). Motor block onset and recovery were 11.27 ± 1.66 min and 6.9 ± 0.84 min, respectively in Group C and 8.63 ± 1.86 min and 9.53 ± 1.07 min, respectively in Group D (P < 0.001) [Figures 1 and 2].


Comparison of clonidine and dexmedetomidine as adjuncts to intravenous regional anaesthesia.

Sardesai SP, Patil KN, Sarkar A - Indian J Anaesth (2015)

Comparison of recovery of sensory and motor block
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4697246&req=5

Figure 2: Comparison of recovery of sensory and motor block
Mentions: There was a significant difference in both groups with respect to mean onset and recovery of sensory and motor block. Sensory block onset and recovery were 6.18 ± 1.07 min and 5.1 ± 1.12 min, respectively in Group C and 4.28 ± 1.23 min and 7.3 ± 1.49 min, respectively in Group D (P < 0.001). Motor block onset and recovery were 11.27 ± 1.66 min and 6.9 ± 0.84 min, respectively in Group C and 8.63 ± 1.86 min and 9.53 ± 1.07 min, respectively in Group D (P < 0.001) [Figures 1 and 2].

Bottom Line: Sensorimotor block onset was significantly faster and recovery delayed with dexmedetomidine as compared to clonidine.Dexmedetomidine significantly facilitates onset, prolongs recovery of sensory as well as motor block and also prolongs duration of analgesia as compared to clonidine.   Both decrease tourniquet pain satisfactorily and have comparable intra-operative fentanyl requirement .Patient satisfaction is better with dexmedetomidine.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Srimati Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India.

ABSTRACT

Background and aims: Intravenous regional anaesthesia (IVRA) provides reliable and rapid analgesia with good muscular relaxation of the extremity distal to the tourniquet, but tourniquet pain and absence of post-operative analgesia are major drawbacks. α2 agonists, clonidine and dexmedetomidine are known to potentiate peripheral nerve blocks. The aim of this study was to compare clonidine and dexmedetomidine as adjuvants to IVRA with respect to block characteristics, tourniquet pain and post-operative analgesia.

Methods: A prospective, randomised, double-blind study was conducted on 60 adult patients of American Society of Anesthesiologists physical status grades I and II, in two groups of 30 each, to receive either clonidine 1 μg/kg or dexmedetomidine 1 μg/kg added to 40 ml 0.5% preservative-free lignocaine. Independent samples t-test was used for analysing demographic data, haemodynamic data and block characteristics and Mann-Whitney U-test for skewed data.

Results: Sensorimotor block onset was significantly faster and recovery delayed with dexmedetomidine as compared to clonidine. Intra-operative visual analogue scale (VAS) at 10 min, 15 min and 40 min and post-operative VAS at 30 min and 2 h were significantly higher with clonidine. Fentanyl consumption and sedation were comparable. Duration of analgesia was significantly longer with dexmedetomidine. Haemodynamic parameters were comparable.

Conclusions: Dexmedetomidine significantly facilitates onset, prolongs recovery of sensory as well as motor block and also prolongs duration of analgesia as compared to clonidine.   Both decrease tourniquet pain satisfactorily and have comparable intra-operative fentanyl requirement . Patient satisfaction is better with dexmedetomidine.

No MeSH data available.


Related in: MedlinePlus