A comparative evaluation of epidural clonidine vs. dexmedetomidine as adjuvants in post-operative analgesia

Veeramachaneni Rajesh, Revathi Lokala, Harshavardhan Venkatayogi

Abstract


Background: Requirement of anesthetic agents is reduced due to addition of adjuvants in epidural anaesthesia as they augment the local anesthetic action and have analgesic properties as well. Effective epidural analgesia ensures stable hemodynamics and satisfactory perioperative period.
Objective: To evaluate efficacy of epidural clonidine compared to dexmedetomidine as adjuvants in postoperative
analgesia
Materials and Methods: Comparative, randomized clinical study was carried out among 100 subjects undergoing abdominal and vaginal hysterectomies of age 44-65 years with ASA grade I and II. They were divided randomly into two group of 50 each. Group A received 17ml of 0.5% of bupivacaine with 2mcg per
kg clonidine. Group B received 17ml of 0.5% of bupivacaine with 1.5mcg per kg dexmedetomidine. Various parameters related to sensory and motor blockade, Ramsay sedation scale for sedation score, Hemodynamic parameters were monitored continuously and recordings were made at regular intervals.
Results: Both groups were comparable in terms of age, weight, duration of surgery, ASA grades and type of surgery. Parameters pertaining to time for onset of sensory and motor block were significantly higher in clonidine group compared to the dexmedetomidine group (p<0.05). Postoperative block duration was significantly higher in dexmedetomidine group compared to clonidine group (p<0.05). The hemodynamic parameters and Ramsay sedation score at pre-operative and at 120min were comparable (p>0.05) between two groups except for heart rate which was significantly less in dexmedetomidine group at 120min
compared to clonidine group (p<0.05).
Conclusion: Dexmedetomidine added to bupivacaine epidurally prolonged postoperative analgesia longer than clonidine.

Keywords: Dexmedetomidine, Clonidine, Bupivacaine, Epidural.


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