Volume : VI, Issue : VIII, August - 2017
Comparative evaluation of clonidine and fentanyl as adjuvants to intrathecal isobaric ropivacaine for lower limb surgeries – A randomised, double blind prospective study.
Amit Kumar, Wasim Mohammad Bhat, Showkat A Gurcoo, Anisur Rehman
Abstract :
Background: Ropivacaine is a safer local anaesthetic than bupivacaine and lignocaine. To improve its quality of anaesthesia and analgesia, the use of adjuvants is recommended. Aim: To compare the efficacy of clonidine and fentanyl as adjuvants to intrathecal isobaric ropivacaine for lower limb surgeries. Design: Randomized double–blind prospective study. Methods: Seventy patients were randomly divided in two groups. Ropivacaine–Clonidine group (RC) received 60 mcg of clonidine with 15 mg of 0.5% isobaric ropivacaine, whereas ropivacaine–fentanyl group (RF) received 25 mcg of fentanyl with 15 mg of 0.5% isobaric ropivacaine intrathecally. Maximum sensory block level, time to achieve maximum sensory block, time for sensory block to regress to L1 dermatome, time to achieve maximum degree of motor block and its regression to Bromage I, sedation score, hemodynamic parameters, and side–effects were noted. Results: The mean onset of maximum sensory block in RC group was was slower than in the RF group (p < .05) .The highest dermatomal level achieved in both groups was T 6. The mean time of sensory regression to L–1 was higher in in RC group (p–value <0.0001). The mean time to achieve Bromage grade IV motor block in RC group was higher ( p >0.05). The motor block was of shorter duration and was subject to rapid recovery in RF group. The mean duration of sensory loss for RC group was higher (p=0.0001). Three patient (8.6%) in the clonidine group had hypotension as compared to one patient (2.8%) in the fentanyl group . Nausea/vomiting and shivering was experienced by one patient each in the fentanyl group. Pruritus was present in three patients (8.6%) in the fentanyl group. Conclusion: Ropivacaine in combination with clonidine or fentanyl provided adequate subarachnoid block for major surgeries, wherein clonidine has advantage over fentanyl as it increased the duration of subarachnoid block and prolonged the postoperative analgesia.
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DOI : 10.36106/ijsr
Cite This Article:
Amit Kumar, Wasim Mohammad Bhat, Showkat A Gurcoo, Anisur Rehman, Comparative evaluation of clonidine and fentanyl as adjuvants to intrathecal isobaric ropivacaine for lower limb surgeries – A randomised, double blind prospective study., INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH : VOLUME-6 | ISSUE-8 | AUGUST‾2017
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References :
Amit Kumar, Wasim Mohammad Bhat, Showkat A Gurcoo, Anisur Rehman, Comparative evaluation of clonidine and fentanyl as adjuvants to intrathecal isobaric ropivacaine for lower limb surgeries – A randomised, double blind prospective study., INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH : VOLUME-6 | ISSUE-8 | AUGUST‾2017
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