A comparative study in the post-operative spine surgeries: Epidural ropivacaine with dexmedetomidine and ropivacaine with clonidine for post-operative analgesia

Abstract

Background:Anaesthesia for spine surgeries is not only concerned with relieving pain during surgeries but also during the post-operative period. A prospective randomised study was carried out to evaluate the efficacy of epidural route and to compare the efficacy and clinical profile of dexmedetomidine and clonidine as an adjuvant to ropivacaine, in epidural analgesia with special emphasis on their quality of analgesia and the ability to provide the smooth post-operative course.Methods:A total of 60 subjects, 33 were men and 27 were women between the age of 18 and 65 years of American Society of Anaesthesiologists (ASA) I/II class who underwent spine surgeries were randomly allocated into two groups, ropivacaine + dexmedetomidine (RD) and ropivacaine + clonidine (RC), comprising 30 patients each. Group RD received 20 ml of 0.2% ropivacaine and 1 μg/kg of dexmedetomidine while group RC received 20 ml of 0.2% ropivacaine and 2 μg/kg of clonidine through the epidural catheter. Onset of analgesia, time of peak effect, duration of analgesia, cardiorespiratory parameters, side-effects and need of rescue intravenous (IV) analgesics were observed.Results:The demographic profile and ASA class were comparable between the groups. None of the patients needed rescue analgesics in either group. Group RD had early onset, early peak effect, prolonged duration and stable cardiorespiratory parameters when compared with group RC. The side-effects profile was also comparable with a little higher incidence of nausea and dry mouth in both groups.Conclusion:Epidural route provided acceptable analgesia in spine surgeries and avoided the need of IV analgesics in either group. Dexmedetomidine is a better neuraxial adjuvant compared with clonidine for providing early onset and prolonged post-operative analgesia and stable cardiorespiratory parameters.

Comparative, Randomized, Prospective, Double Blinded, Evaluation of Epidural Ropivacaine with Dexmedetomidine or Fentanyl as Adjuvants in Patients Undergoing Total Abdominal Hystrectomy

“…Results of our study showed that total duration of sensory block was significantly longer in group DR as compared to group FR being 413.33 ± 66.71 minutes & 354.66 ± 66.88 minutes respectively. Sensory and motor levels onset, regression and total duration observed in our study were almost similar with studies done by Bajwa et al, Salgado et al, Saravanababu et al and Christelis N et al [9][10][11][12][13] Group FR…”

“…This result is corroborated by many other authors. [9][10][11][12][13] Onset of attainment of modified Bromage scale III was significantly faster in group DR than group FR. Median value for highest sensory dermatomal level achieved in group DR was T3, being present in 40% patients whereas none of the patients in group FR achieved value of T3 [Table 3, Figure 1].…”

Efficacy of clonidine as an adjuvant to ropivacaine in supraclavicular brachial plexus block: A prospective study

“…Clonidine, an imidazoline with selective partial agonist activity at α-2 adrenergic receptors has been used for many years as a centrally acting antihypertensive agent and has also been used as an adjuvant with ropivacaine for regional anaesthesia including epidural anaesthesia. [ 5 6 ] The use of α-2 adrenoceptor agonist for enhancement of peripheral nerve blocks has added a new dimension to their clinical application. [ 7 ]…”

Effect of Addition of Clonidine to Bupivacaine in Spinal Anesthesia on Analgesia After Cruciate Ligament Repair: A Randomized Double-Blinded Clinical Trial

“…Anterior Cruciate Ligament (ACL) is injured in athletes and trauma victims ( 3 , 4 ). The exact incidence rate of ACL rupture is unknown, and it is best repaired via arthroscopy (3).…”

“…The exact incidence rate of ACL rupture is unknown, and it is best repaired via arthroscopy (3). The optimal anesthesia technique for this procedure is the regional anesthesia technique ( 4 ).…”