Abstract
Aim: To compare the clinical effects of combined doses of Ropivacaine and Clonidine.
Material and Methods: Ninety patients between 20-60 years, ASA I and II category who were posted for lower limb surgery were included in the study with informed consent and were randomly assigned to three groups. Group Ropivacaine 15 mg (Group R), Group Ropivacine 15mg+Clonidine15 µg (Group R-C15), Group Ropivacaine 15mg + Clonidine 30 µg (Group R-C30). Intraoperative hemodynamics, onset and duration of sensory and motor block, analgesia and adverse effects were noted.
Results: There was no significant difference in onset and quality of sensory and motor block in all three groups. Groups R-C15 and R-C30 had prolonged duration of sensory and motor block as compared to group R. Time for regression of sensory block upto L1 dermatome was significantly prolonged in Groups R-C15 and R-C30 as compared to group R. Mean duration of complete and effective analgesia was in the order Group R-C30>Group R-C15>Group R and the difference was statistically significant.
Conclusion: Addition of clonidine15 µg and 30 µg to intrathecal ropivacaine produces dose dependent increase in the duration of sensory and motor blockade as well as duration of analgesia without affecting hemodynamics or safety.
Keywords: Intathecal, Ropivacaine, Clonidine, Lower extremity surgery.
References
- Hampl KL, Schneider MC, Ummenhoffer W, Drewe J: Transient neurologic symptoms after spinal anesthesia. AnesthAnalg 1995; 81:1148-53.
- Harada Y, Nishioka K, Kitahata LM. Visceral antinociceptive effects of spinal clonidine combined with Morphine, (D - Pen2, D - Pen5) enkephalin or U50, 488H. Anesthesiology 1995; 83(2):344-352.
- Aydınl I. Ropivakain. AnesteziDergisi1997; 5:143-146.
- De Kock M, Gautier P, Fanard L, et al İntrathecal ropivacaine and clonidine for ambulatoryknee arthroscopy. Anesthesiol-ogy 2001; 94: 574-8.
- Xin-zhong Chen et al Dose-response study of spinal hyperbaric ropivacaine for cesareansection [J Zhejiang Univ SCIENCE B 2006 7 (12):992- 997].
- Ying Y. Lee.Spinal ropivacaine for lower limb surgery. A dose response study. [Ana-esthesia & Analgesia 2007:105(520-523)].
- Gonul Sagiroglu, The Effects of Adding Various Doses of Clonidine to Ropivacaine in Spinal Anesthesia- EAJM: 41, December 2009
- Racle JP, Benkhadra A, Poy JY, Gleizal B. Prolongation of isobaric bupivacaine spinal anesthesia with epinephrine and clonidine for hip surgery in the elderly. AnesthAnalg 1987; 66: 442–6.
- Mc Namee DA, Parks L, Mc Clelland AM, et al. İntrathecal ropivacaine for total hiparthroplasty: double-blind comparative studywith isobaric 7.5 % mg ml-1 and 10 mgml-1solutions. Br J Anaesth 2001; 87: 74
- Van Kleef JW, Veering B, Burm A. Spinal anesthesia with ropivacaine: a double-blind study on the efficacy and safety of 0.5 %and 0.75 % solutions in patients undergoing minor lower limb surgery. Anesth Analg 1994; 78:1125-3
- S KurdiMadhuri et al Use of Ropivacaine intrathecally. J Anaesthesiol Clin Pharm-acolv. 26(4); Oct-Dec 2010.
- Rodrigo A, Aghajanian GK. Opiate- and alpha2 -adrenoceptor-induced hyperpolarize-tions of locus ceruleus neurons in brain slices: Reversal by cyclic adenosine 3':5'-monophosphate analogues. J Neurosci 1985; 5: 235.
- Hayashi Y, Maze M. Alpha2- adrenoceptor agonist and anaesthesia. Br J Anaesth 1993;71: 108-18.
Corresponding Author
Dr Bhawani Singh c/o Dr Nihar Sharma
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