Abdominal hysterectomy under epidural block: Comparison between bupivacaine with clonidine versus ropivacaine with clonidine

Dr Bishnupriya; Dr Shilpi Misra

Volume : V, Issue : I, January - 2016

Abdominal hysterectomy under epidural block: Comparison between bupivacaine with clonidine versus ropivacaine with clonidine

Dr Bishnupriya, Dr Shilpi Misra

Abstract :

CONTEXT: Abdominal hysterectomy is one of the most common non–pregnancy related gynecological surgeries performed. Regional anesthesia (spinal/epidural/combined) offers several advantages for these surgeries lowering the risk associated with general anesthesia. Bupivacaine used to be the most common anesthetic agents for epidural block, however, in recent years; ropivacaine has increasingly replaced bupivacaine because of its similar analgesic properties, lesser motor blockade and decreased propensity of Cardio toxicity. Neuraxial adjuvant like Clonidine augments the action of local anesthetics. AIMS: Comparison of onset, duration of sensory and motor block and any adverse effects between 0.5%bupivacaine with clonidine versus 0.5% ropivacaine with clonidine (75microgram /kg). Setting and Design: This Prospective randomized study was carried out in 50 patients (25 in each group) of ASA grade 1 and 2 scheduled for abdominal hysterectomy. Materials and Methods: Epidural block was administered GROUP–1 (BC): Epidural bupivacaine 20 ml (0.5%) with 0.75 �g/kg clonidine GROUP–2 (RC): Epidural ropivacaine 20 ml (0.5%) with 0.75 �g/kg clonidine Onset, duration of sensory–motor block, heart rate, blood pressure, oxygen saturation and respiratory rate were recorded. Statistical analysis: The statistical analysis was done using SPSS (Statistical Package for Social Sciences) Version 15.0.Chi–square test, ANOVA , Student�s t–test and Paired t–test were used. Results: Groups were comparable with regard to demographic data, hemodynamic stability. Onset of sensory and motor blockade was faster in RC Group as compared to BC group. Recovery of motor block was early in RC Group. No potential side effect like adycardia or hypotension was seen in either group. Conclusion: Although clonidine as adjuvant can be used safely to both bupivacaine as well as ropivacaine in abdominal hysterectomy under epidural block, but on account of faster onset, hemodynamic stability and early recovery of motor block ropivacaine with clonidine seems to be a better option.