Key result
Adding clonidine to bupivacaine-fentanyl prolongs sensory and motor blockade and analgesia versus bupivacaine-clonidine.
Why the study?
Does adding low dose clonidine to a bupivacaine-fentanyl mixture improve peri-operative analgesia in patients undergoing major orthopaedic lower limb surgeries?
RCT (n=90)
Double-blind
randomly divided
Does adding low dose clonidine to a bupivacaine-fentanyl mixture improve peri-operative analgesia in patients undergoing major orthopaedic lower limb surgeries?
Adding low dose clonidine to a bupivacaine-fentanyl mixture improves the quality of peri-operative analgesia without significant side effects in major orthopaedic lower limb surgeries.
May improve spinal block quality with low-dose clonidine; hypothesis-generating and requires larger trials before practice change.
Introduction: With side effects of central neuroaxial opioids or of high dose intrathecal clonidine in combination with bupivacaine in spinal anaesthesia, my study is to ascertain if small dose of clonidine when added to bupivacaine-fentanyl mixture improves spinal anaesthesia, without producing side effects, as compared to bupivacaine-fentanyl or bupivacaineclonidine mixture. Methods: It's a prospective, double blinded randomised study of 90 ASA grade I-II patients, aged between 20-60 yrs, of either sex, weighing between 40-70 kgs, scheduled for major orthopaedic surgeries. Patients were randomly divided into 3 groups of 30 patients each as Group I (BCF): Bupivacaine 0.5%H 2.6ml + Fentanyl 20mcg + Clonidine 30mcg Group II (BC): Bupivacaine 0.5%H 2.6ml + Clonidine 30mcg Group III (BF): Bupivacaine 0.5%H 2.6ml + Fentanyl 20mcg Duration of sensory and motor blockade and effective analgesia mean time till two segment regression, haemodynamic profile, post-op pain and analgesia requirement were recorded. Results: The duration of sensory and motor blockade, effective analgesia and mean time till two segment regression were significantly longer in group BCF as compared to group BC (P – 0.002) and in group BC as compared to group BF (P – 0.01). The incidence of intra-op pain and requirement of postop analgesia in the first 24 hours was significantly more in group BF as compared to other groups (P-0.01). Conclusion: Low dose Clonidine when added to Bupivacaine-Fentanyl mixture improves the quality of peri-op analgesia without significant side effects.
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Shah et al. (2018) conducted an RCT in Major orthopaedic lower limb surgeries (n=90). Clonidine added to Bupivacaine-Fentanyl mixture vs. Bupivacaine-Clonidine mixture and Bupivacaine-Fentanyl mixture was evaluated on Duration of sensory and motor blockade, effective analgesia and mean time till two segment regression (p=0.002). Adding 30mcg clonidine to a bupivacaine-fentanyl mixture significantly prolonged sensory and motor blockade and effective analgesia compared to a bupivacaine-clonidine mixture (P=0.002).
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