Volume : 6, Issue : 12, December - 2017

HAEMODYNAMIC AND ANALGESIC PROFILE OF DIFFERENT DOSES OF CLONIDINE WITH SMALL DOSE OF BUPIVACAINE UNDER SPINAL ANAESTHESIA IN LOWER ABDOMINAL SURGERIES.

Sonali Beniwal, Pratibha Rathore

Abstract :

<p>&nbsp;<b><span style="font-size:12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Objective :&nbsp; </span></b><span style="font-size: 12pt; line-height: 200%; font-family: &quot;Times New Roman&quot;, serif;">To&nbsp; find &nbsp;out &nbsp;the &nbsp;lowest&nbsp; possible &nbsp;dose &nbsp;of Clonidine &nbsp;that &nbsp;can &nbsp;prolong &nbsp;the &nbsp;duration &nbsp;of &nbsp;sensory &nbsp;and motor &nbsp;anesthesia &amp; analgesia &nbsp;with &nbsp;minimal &nbsp;dose &nbsp;of Bupivacaine &nbsp;without &nbsp;undue &nbsp;side &nbsp;effects.&nbsp; <b>Methods :</b> In&nbsp; this&nbsp; prospective&nbsp; randomized &nbsp;double &nbsp;blind &nbsp;study&nbsp; 90 &nbsp;ASA &nbsp;grade &nbsp;1 &nbsp;&amp; &nbsp;2 &nbsp;patients &nbsp;were randomly allocated &nbsp;in &nbsp;3 &nbsp;groups. All &nbsp;receive &nbsp;6 &nbsp;mg &nbsp;Bupivacaine &nbsp;with 15ug &nbsp;of &nbsp;Clonidine &nbsp;in&nbsp; group&nbsp; 1,&nbsp; 45ug &nbsp;of &nbsp;Clonidine &nbsp;in&nbsp; &nbsp;Group 2 ,&nbsp; 75ug &nbsp;of &nbsp;Clonidine &nbsp;in &nbsp;group&nbsp; 3 .&nbsp; <b>Result :</b>&nbsp; Onset &nbsp;of &nbsp;sensory &nbsp;analgesia &nbsp;&amp; &nbsp;motor &nbsp;blockade &nbsp;up to &nbsp;maximal &nbsp;level &nbsp;was &nbsp;achieved &nbsp;faster &nbsp;with &nbsp;75ug &nbsp;dose (sensory 9.6&nbsp; &plusmn; 0.67&nbsp; min &nbsp;&amp; &nbsp;motor &nbsp;13.63 &plusmn; 0.45 &nbsp;min) . The &nbsp;addition &nbsp;of &nbsp;Clonidine &nbsp;to &nbsp;Bupivacaine&nbsp; &nbsp;and &nbsp;increasing &nbsp;its &nbsp;dose &nbsp;delays &nbsp;the &nbsp;time &nbsp;for 2 segment &nbsp;sensory &nbsp;regression&nbsp; (149. &plusmn;3.61min) , regression &nbsp;to &nbsp;segment &nbsp;L1&nbsp; &nbsp;(246.72&plusmn;2.58 &nbsp;min), increases &nbsp;&nbsp;the &nbsp;duration &nbsp;of &nbsp;motor &nbsp;blockade &nbsp;(200.83&plusmn;2.73 min)&nbsp; &nbsp;&amp;&nbsp; &nbsp;time to&nbsp; &nbsp;walking&nbsp; &nbsp;&nbsp;(320.83 &plusmn;3.18min) &nbsp;&amp; &nbsp;voiding (392.47&plusmn;3.53min). &nbsp;It also &nbsp;increases&nbsp; &nbsp;the&nbsp; &nbsp;time &nbsp;to &nbsp;1^st analgesic&nbsp; &nbsp;requested &nbsp;(339&plusmn;3.32min). &nbsp;The incidence&nbsp;&nbsp; of&nbsp; postoperative&nbsp; complications&nbsp;&nbsp; was &nbsp;not significantly&nbsp;&nbsp; different&nbsp; in &nbsp;between &nbsp;different &nbsp;doses &nbsp;of Clonidine.&nbsp; <b>Conclusion :</b> &nbsp;75ug &nbsp;is &nbsp;the &nbsp;preferred &nbsp;dose , in&nbsp; &nbsp;terms &nbsp;of effect &nbsp;versus &nbsp;side &nbsp;effects , when &nbsp;prolongation &nbsp;of &nbsp;spinal&nbsp; &nbsp;anesthesia &nbsp;is &nbsp;desired &nbsp;as &nbsp;in &nbsp;lower &nbsp;abdominal &nbsp;surgeries.&nbsp;&nbsp;</span></p> <p class="MsoNormal" style="line-height:200%"><span style="font-size:&#10;12.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;"><b><o:p></o:p></b></span></p>