Original Research Article
Year: 2018 | Month: October | Volume: 5 | Issue: 10 | Pages: 8-16
Comparative Evaluation of Epidural Clonidine and Dexmedetomidine in Post Operative Analgesia
Dr Gynendra Kumar Gautam1, Dr Manoj Kumar Chaurasia2
1FNB Trainee in Critical Care Medicine, Sir Ganga Ram Hospital, New Delhi
2Assistant Professor, Dept. of Anesthesia, G.S.V.M. Medical College, Kanpur.
Corresponding Author: Dr Manoj Kumar Chaurasia
ABSTRACT
Background and Aims: Clonidine and dexmedetomidine are a-2 adrenergic agonists with analgesic proprieties which potentiate local anesthetic effects when epidurally administered.
The present study was undertaken with following aims: 1. To compare onset & duration of analgesia, incidence of side effects and complications of epidural clonidine and dexmedetomidine in post operative analgesia. 2. To study the potentiating effect of epidural clonidine /dexmedetomidine associated with ropivacaine (0.2%)
3. To know hemodynamics related to epidural clonidine and dexmedetomidine.
Materials & Methods: After taking institutional approval and consent from patients, the study was carried out on 60 patients of A.S.A. grade I and grade II between 18-50 years. All patients were divided into two groups group 1 and 2 randomly.
Group -1: received Ropivacaine 0.2% plus clonidine 1 mcg/kg
Group -2: received Ropivacaine 0.2% plus dexmedetomidine 1 mcg/kg.
Result: Statistically significant values were observed on comparison of post-operative block characteristics among the two groups (p < 0.001), both for time to two segment regression and time for first rescue top-up. Dexmedetomidine provided a smooth and prolonged post-operative analgesia as compared to clonidine. There was significant change in VAS score at 5 and 10 min post injection of drug in both groups as p value is <0.001 (very highly significant) at both time intervals, but mean VAS sore were higher in clonidine group in comparison to Dexmedetomidine group. There was decreasing trend of mean Pulse rate after 4 hours post injection & this decrease was very highly significant in the RC group (group 1) compared to RD group (group 2). The incidence of dry mouth was significantly higher in both the groups but it was statistically non-significant on comparison (P > 0.05).
Conclusion: Dexmedetomidine is a better adjuvant than clonidine in epidural post operative analgesia as far as patient comfort, stable cardio-respiratory parameters, and post-operative analgesia is concerned.
Key words: Dexmedetomidine, clonidine, ropivacaine, post-operative analgesia, gynecological surgeries.
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