What is it about?
Comparative Study of Dexmedetomidine and Clonidine as Adjuvants to Isobaric Ropivacaine 0.75%
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Why is it important?
Background: Epidural anesthesia is very popular for infraumbilical surgeries. Epidural form of central neuraxial blockade techniques avoid the disadvantages associated with general anesthesia like airway manipulations, polypharmacy and other untoward effects like postoperative nausea, vomiting and need for supplemental intravenous analgesics. Amongst different local anesthetic drugs used, Ropivacaine, being pure S-enantiomer of bupivacaine is the recently introduced long acting amide anesthetic agent is claimed to be better in its cardiovascular profile. Αlpha 2 (α2) adrenergic receptor agonists have both analgesic and sedative properties when used as an adjuvant to local anesthetic in regional anesthesia. Methodology: A double blind prospective randomized control study conducted at tertiary health care institute to evaluate and compare the efficacy, block characteristics and postoperative analgesia of 1.5 μg/kg Dexmedetomidine in comparison to 2 μg/kg Clonidine as adjuncts to 0.75% isobaric Ropivacaine in epidural anesthesia for infraumbilical surgeries. Results: Meantime for onset of sensory and motor blockade, meantime for maximum sensory blockade and meantime for complete motor blockade was earlier with dexmedetomidine than with Clonidine as epidural adjuvant. Total duration of sensory and motor blockade was considerably longer in group receiving dexmedetomidine. Higher dermatomal level of sensory blockade, longer postoperative analgesia with better sedation was achieved by group receiving dexmedetomidine with comparative stable hemodynamics as compared to group receiving Clonidine. Conclusion: Dexmedetomidine is a better alternative to Clonidine as an adjuvant to 0.75% isobaric Ropivacaine in epidural anesthesia for providing early onset of sensory and motor blockade, desirable sedation and prolonged postoperative analgesia.
Perspectives
Background: Epidural anesthesia is very popular for infraumbilical surgeries. Epidural form of central neuraxial blockade techniques avoid the disadvantages associated with general anesthesia like airway manipulations, polypharmacy and other untoward effects like postoperative nausea, vomiting and need for supplemental intravenous analgesics. Amongst different local anesthetic drugs used, Ropivacaine, being pure S-enantiomer of bupivacaine is the recently introduced long acting amide anesthetic agent is claimed to be better in its cardiovascular profile. Αlpha 2 (α2) adrenergic receptor agonists have both analgesic and sedative properties when used as an adjuvant to local anesthetic in regional anesthesia. Methodology: A double blind prospective randomized control study conducted at tertiary health care institute to evaluate and compare the efficacy, block characteristics and postoperative analgesia of 1.5 μg/kg Dexmedetomidine in comparison to 2 μg/kg Clonidine as adjuncts to 0.75% isobaric Ropivacaine in epidural anesthesia for infraumbilical surgeries. Results: Meantime for onset of sensory and motor blockade, meantime for maximum sensory blockade and meantime for complete motor blockade was earlier with dexmedetomidine than with Clonidine as epidural adjuvant. Total duration of sensory and motor blockade was considerably longer in group receiving dexmedetomidine. Higher dermatomal level of sensory blockade, longer postoperative analgesia with better sedation was achieved by group receiving dexmedetomidine with comparative stable hemodynamics as compared to group receiving Clonidine. Conclusion: Dexmedetomidine is a better alternative to Clonidine as an adjuvant to 0.75% isobaric Ropivacaine in epidural anesthesia for providing early onset of sensory and motor blockade, desirable sedation and prolonged postoperative analgesia.
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This page is a summary of: Comparative Study of Dexmedetomidine and Clonidine as Adjuvants to Isobaric Ropivacaine 0.75% for Epidural Anesthesia in Infraumbilical Surgeries, Indian Journal of Anaesthesia and Analgesia, January 2020, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.7120.34.
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