What is it about?
Isobaric Ropivacaine (0.75%) with Adjuvants Clonidine and Dexmedetomidine Administered Intrathecally
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Why is it important?
Spinal anesthesia is unparalleled in the way a small dose of local anesthetic, virtually devoid of systemic pharmacologic effect, can produce profound surgical anesthesia. The quality and duration of analgesia is improved when a local anesthetic is combined with alpha 2 adrenergic agonist. Here we evaluate the clinical effects of the adjuvants, α2 agonists-dexmedetomidine 5 mcg and clonidine 15 mcg in conjunction with intrathecal isobaric ropivacaine 0.75% for lower limb surgeries and assessing 1. The onset and duration of sensory block 2. The onset and duration of motor block 3. The duration of analgesia 4. Hemodynamic changes. Material and Methods: Prospective study was done on patients undergoing lower limb surgeries under neuraxial block were split into three equivalent groups. Group RR: subjects received 3 ml of isobaric Ropivacaine 0.75% with sterile water 0.1 ml (total=3.1 ml), Group RC: subjects 3 ml isobaric Ropivacaine 0.75% with clonidine 15 mcg (total=3.1 ml), Group RD: subjects 3 ml isobaric Ropivacaine 0.75% with dexmedetomidine 5 mcg (total=3.1 ml). Result: Statistical analysis shows significant difference in onset, duration of sensory and motor block and duration of analgesia among three Groups, Group RD, RC and RR. The time of onset of sensory, motor block was earlier and duration of sensory, motor block was longer and duration of analgesia (time to requirement of first rescue analgesic) prolonged in Group RD as compared to Group RC and Group RR. Conclusion: Dexmedetomidine with isobaric ropivacaine 0.75% produces more rapid onset of sensory and motor block, prolonged duration of sensory and motor block and longer duration of analgesia than clonidine with isobaric ropivacaine 0.75% and isobaric ropivacaine 0.75% alone intrathecally.
Perspectives
Spinal anesthesia is unparalleled in the way a small dose of local anesthetic, virtually devoid of systemic pharmacologic effect, can produce profound surgical anesthesia. The quality and duration of analgesia is improved when a local anesthetic is combined with alpha 2 adrenergic agonist. Here we evaluate the clinical effects of the adjuvants, α2 agonists-dexmedetomidine 5 mcg and clonidine 15 mcg in conjunction with intrathecal isobaric ropivacaine 0.75% for lower limb surgeries and assessing 1. The onset and duration of sensory block 2. The onset and duration of motor block 3. The duration of analgesia 4. Hemodynamic changes. Material and Methods: Prospective study was done on patients undergoing lower limb surgeries under neuraxial block were split into three equivalent groups. Group RR: subjects received 3 ml of isobaric Ropivacaine 0.75% with sterile water 0.1 ml (total=3.1 ml), Group RC: subjects 3 ml isobaric Ropivacaine 0.75% with clonidine 15 mcg (total=3.1 ml), Group RD: subjects 3 ml isobaric Ropivacaine 0.75% with dexmedetomidine 5 mcg (total=3.1 ml). Result: Statistical analysis shows significant difference in onset, duration of sensory and motor block and duration of analgesia among three Groups, Group RD, RC and RR. The time of onset of sensory, motor block was earlier and duration of sensory, motor block was longer and duration of analgesia (time to requirement of first rescue analgesic) prolonged in Group RD as compared to Group RC and Group RR. Conclusion: Dexmedetomidine with isobaric ropivacaine 0.75% produces more rapid onset of sensory and motor block, prolonged duration of sensory and motor block and longer duration of analgesia than clonidine with isobaric ropivacaine 0.75% and isobaric ropivacaine 0.75% alone intrathecally.
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This page is a summary of: Comparative Study of Isobaric Ropivacaine (0.75%) and Isobaric Ropivacaine (0.75%) with Adjuvants Clonidine and Dexmedetomidine Administered Intrathecally in Adult Patients Undergoing Lower Limb Surgeries, Indian Journal of Anaesthesia and Analgesia, July 2020, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.7420.11.
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