Original Research Article
Year: 2018 | Month: December | Volume: 5 | Issue: 12 | Pages: 297-311
A Comparative Evaluation of Clonidine, Dexmedetomidine and Neostigmine Used as Adjuvants to 0.5% Bupivacaine in Epidural Anaesthesia for Lower Limb and Lower Abdominal Surgery
Iram Shokat1, Mubashar Akram2, Anumeha Jain1, Abhinav Mani2
1Department of Anaesthesia, National Institute of Medical Sciences, Jaipur
2Department of Surgery, Government Medical College Jammu
Corresponding Author: Mubashar Akram
ABSTRACT
Background:- Bupivacaine is the standard local anaesthetic agent for intrathecal/epidural analgesia. Adjuvants are often added to improve analgesia and reduce the dose of bupivacaine thereby decreasing the cost of the drug used and minimize side effects.
Aim:- A comparative evaluation of clonidine, dexmedetomidine and neostigmine used as adjuvants to 0. 5% bupivacaine in epidural anaesthesia for lower limb and lower abdominal surgery.
Design and Place:- This is a comparative study which was carried out in 80(eighty) patients admitted in National Institute Of Medical Sciences & Research, Jaipur over a period of one year w.e.f. November 2017 to November 2018.
Method:- 80 patients of either sex ranging in age from 18-60 years, scheduled for lower limb and lower abdominal surgeries were divided into four study groups randomly by an investigator not directly linked to the study. All patients were given epidural anaesthesia for undergoing the proposed surgery. Epidural Neostigmine, Clonidine or Dexmedetomidine was added to bupivacaine depending upon the patient group and results in terms of efficacy, safety and prolongation of analgesic effect were noted.
Result: - The use of these adjuvants prolonged the post operative analgesia and the prolongation was maximum in Dexmedetomidine group followed by Clonidine and then the Neostigmine group.Conclusion: When these non opioid adjuvants are added to 0.5% Bupivacaine in epidural anaesthesia, they prolong the analgesic effect with added advantage of opioid sparing effect as the use of epidural opioids is always associated with increased incidence of unwanted side effects.
Key words: Neostigmine, Clonidine, Dexmedetomidine, Bupivacaine, Epidural Anaesthesia.
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