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Comparison of the Efficacy of Neuraxial Blockade Analgesic Effect between Intrathecal Clonidine

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Background: A number of adjuvants in the form of opioids analgesics were routinely used intrathecally to prolong the analgesia effect both in the intraoperative and postoperative period. Clonidine and tramadol were the common agents used intrathecally along with bupivacaine for increasing the duration of analgesia. Aim: To assess and compare the neuraxial blockade analgesic effect between intrathecal clonidine and intrathecal tramadol along with 0.5% hyperbaric bupivacaine for lower limb surgeries. Methodology: A prospective double blinded randomized study was conducted for a period of one year at Dhanalakshmi Srinivasan Medical College and Hospital. A total of 100 patients who had been posted for elective lower limb surgery were included in our study and they were randomized into two groups of 50 each. Group A patients received clonidine hydrochloride 37.5 mcg (0.25 ml) and Group B patients received tramadol 25 mg (0.5 ml) and both the groups received 0.5% hyperbaric bupivacaine hydrochloride (3 ml) along with normal saline. Assessment of pain score was done using VAS scale and the motor blockade was assessed using Bromage motor blockade score and the vital parameters were also assessed along with it. Results: The onset of sensory analgesia was found to be much faster and the duration of sensory analgesia was found to be more prolonged among the group which received clonidine and the pain score which was measured using VAS was higher among the patients who received tramadol and the difference was found to be statistically significant (p < .05). The duration of motor function recovery was almost similar in both the groups and no significant side effects reported between the two groups. Conclusion: Both the groups were effective in producing adequate surgical anesthesia with hemodynamic stability without causing serious adverse events but clonidine group was found to have a faster onset of action with prolonged duration of analgesia.

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Background: A number of adjuvants in the form of opioids analgesics were routinely used intrathecally to prolong the analgesia effect both in the intraoperative and postoperative period. Clonidine and tramadol were the common agents used intrathecally along with bupivacaine for increasing the duration of analgesia. Aim: To assess and compare the neuraxial blockade analgesic effect between intrathecal clonidine and intrathecal tramadol along with 0.5% hyperbaric bupivacaine for lower limb surgeries. Methodology: A prospective double blinded randomized study was conducted for a period of one year at Dhanalakshmi Srinivasan Medical College and Hospital. A total of 100 patients who had been posted for elective lower limb surgery were included in our study and they were randomized into two groups of 50 each. Group A patients received clonidine hydrochloride 37.5 mcg (0.25 ml) and Group B patients received tramadol 25 mg (0.5 ml) and both the groups received 0.5% hyperbaric bupivacaine hydrochloride (3 ml) along with normal saline. Assessment of pain score was done using VAS scale and the motor blockade was assessed using Bromage motor blockade score and the vital parameters were also assessed along with it. Results: The onset of sensory analgesia was found to be much faster and the duration of sensory analgesia was found to be more prolonged among the group which received clonidine and the pain score which was measured using VAS was higher among the patients who received tramadol and the difference was found to be statistically significant (p < .05). The duration of motor function recovery was almost similar in both the groups and no significant side effects reported between the two groups. Conclusion: Both the groups were effective in producing adequate surgical anesthesia with hemodynamic stability without causing serious adverse events but clonidine group was found to have a faster onset of action with prolonged duration of analgesia.

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This page is a summary of: Comparison of the Efficacy of Neuraxial Blockade Analgesic Effect between Intrathecal Clonidine and Tramadol as An Adjuvant with 0.5% Bupivacaine, Indian Journal of Anaesthesia and Analgesia, January 2020, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.7120.29.
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