Key result
Levobupivacaine with clonidine significantly reduced the need for shoulder tip pain treatment compared to ropivacaine with clonidine (16.67% vs 96.67%, p<0.001) during laparoscopic cholecystectomy.
Why the study?
Does epidural levobupivacaine with clonidine improve analgesic efficacy and safety compared to ropivacaine with clonidine in patients undergoing laparoscopic cholecystectomy?
RCT (n=60)
Single-blind
Table of random numbers
No
Does epidural levobupivacaine with clonidine improve analgesic efficacy and safety compared to ropivacaine with clonidine in patients undergoing laparoscopic cholecystectomy?
Absolute Event Rate: 16.67% vs 96.67%
p-value: p=<0.001
Levobupivacaine with clonidine provides better analgesia for shoulder pain but causes more significant hypotension requiring vasopressors compared to ropivacaine with clonidine during thoracic epidural block for laparoscopic cholecystectomy.
Favors levobupivacaine-clonidine for shoulder analgesia despite greater hypotension risk; extends thoracic epidural agent comparisons in laparoscopic cholecystectomy.
INTRODUCTION: Laparoscopic cholecystectomy has traditionally been performed under general anesthesia, however, with the development and advancement of newer surgical and anesthetic techniques, approaches using regional anaesthesia are emerging as a viable and useful alternative. This study was conducted to compare the postoperative analgesic efficacy and safety of levobupivacaine with clonidine and ropivacaine with clonidine. MATERIAL AND METHODS: A randomized single-blind controlled trial was done with 60 patients of American Society of Anesthesiologists Grade I or II status undergoing laparoscopic cholecystectomy. Group I (N = 30) (patients n = 30) received epidural anesthesia 0.5% (2 mg/kg) levobupivacaine with 1.2 g/kg clonidine. Whereas group II (N=30) received epidural anesthesia 0.75% (3 mg/kg) ropivacaine with 1.2 g/kg clonidine.. Vital parameters were recorded. RESULTS: In both the groups, throughout the procedure, mean heart rate and blood pressure levels were either significantly lower or comparable to the baseline levels. In both the groups most of the times hypotensive effect of anaesthetic agents was observed. CONCLUSION: Levobupivacaine with clonidine provided an early and longer block and showed lesser analgesic need for shoulder pain as compared to ropivacaine with clonidine yet both the groups showed a high decline in blood pressure that necessitated the vasopressor use.
No takes yet. Share an insight, caveat, or question.
Pandey et al. (2015) conducted an RCT in Laparoscopic cholecystectomy (n=60). Levobupivacaine with clonidine vs. 0.75% (3 mg/kg) ropivacaine with 1.2 µg/kg clonidine was evaluated on Requirement of treatment for shoulder tip pain with 25 mg Ketamine (p=<0.001). Levobupivacaine with clonidine significantly reduced the need for shoulder tip pain treatment compared to ropivacaine with clonidine (16.67% vs 96.67%, p<0.001) during laparoscopic cholecystectomy.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: