What is it about?
Clonidine, Fentanyl or their Combination for Postoperative Epidural Analgesia
Featured Image
Photo by Tim Mossholder on Unsplash
Why is it important?
Background: Prolonged postoperative analgesia helps in early ambulation and prevents chronic postsurgical pain. Hence, effectiveness of using a combination of two adjuvants with ropivacainefor epidural analgesia is required to be known. Objectives: To compare the effectiveness, duration of postoperative analgesia and side effects of fentanyl and clonidine used alone with ropivacaine or in combination. Materials and Methods: 105 American Society of Anaesthesiologists physical statusclass1 and 2 patients with 18 to 70 years of age posted for elective lower limb surgeries under combined spinal epidural technique were randomly assigned into 3 equal groups. Surgery was done under spinal anaesthesia and postoperatively, Group RC received 8ml 0.2% Ropivacaine + Clonidine 60mcg, Group RF received 8ml 0.2% Ropivacaine + Fentanyl 75mcg and Group RFC received 8ml 0.2% Ropivacaine + Clonidine 30mcg + Fentanyl 37.5mcg epidurally. The Visual Analogue Scores, onset of analgesia, peak effect of analgesia, duration of analgesia, haemodynamic parameters and side effects in each group were recorded and statistically analysed with p<0.05 considered as significant. Results: Group RFC had faster onset of analgesia, earlier peak analgesic effect and longer duration of analgesia compared to group RC and RF. VAS scores were comparable between group RC and RFC. No statistically significant difference between the groups was noted with respect to haemodynamic parameters. Only one patient had nausea and vomiting in group RFC. Conclusion: Both clonidine and fentanyl can be used as adjuvants in lower doses without compromising the analgesic efficacy and also lower the incidence of side effects.
Perspectives
Background: Prolonged postoperative analgesia helps in early ambulation and prevents chronic postsurgical pain. Hence, effectiveness of using a combination of two adjuvants with ropivacainefor epidural analgesia is required to be known. Objectives: To compare the effectiveness, duration of postoperative analgesia and side effects of fentanyl and clonidine used alone with ropivacaine or in combination. Materials and Methods: 105 American Society of Anaesthesiologists physical statusclass1 and 2 patients with 18 to 70 years of age posted for elective lower limb surgeries under combined spinal epidural technique were randomly assigned into 3 equal groups. Surgery was done under spinal anaesthesia and postoperatively, Group RC received 8ml 0.2% Ropivacaine + Clonidine 60mcg, Group RF received 8ml 0.2% Ropivacaine + Fentanyl 75mcg and Group RFC received 8ml 0.2% Ropivacaine + Clonidine 30mcg + Fentanyl 37.5mcg epidurally. The Visual Analogue Scores, onset of analgesia, peak effect of analgesia, duration of analgesia, haemodynamic parameters and side effects in each group were recorded and statistically analysed with p<0.05 considered as significant. Results: Group RFC had faster onset of analgesia, earlier peak analgesic effect and longer duration of analgesia compared to group RC and RF. VAS scores were comparable between group RC and RFC. No statistically significant difference between the groups was noted with respect to haemodynamic parameters. Only one patient had nausea and vomiting in group RFC. Conclusion: Both clonidine and fentanyl can be used as adjuvants in lower doses without compromising the analgesic efficacy and also lower the incidence of side effects.
Red Flower Publication Publications
Red Flower Publication Pvt Ltd
Read the Original
This page is a summary of: Clonidine, Fentanyl or their Combination for Postoperative Epidural Analgesia in Lower Limb Surgeries: Comparative Study, Indian Journal of Anaesthesia and Analgesia, January 2018, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.51018.7.
You can read the full text:
Contributors
The following have contributed to this page
