Comparative analysis of duration of postoperative analgesia between levobupivacaine and levobupivacaine with clonidine after ultrasound-guided transversus abdominis plane block in patients undergoing lower segment cesarean section

Acharya, Ranjita; Baksi, Ranjita; Mohapatra, Pratik

doi:10.4103/aer.aer_163_18

Cited by 13 publications

(6 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Earlier studies done of cesarean patients have also demonstrated similar effect. [ 3 , 6 ] However, another study done by Bollag et al . [ 7 ] reported no change in short- and long- term pain scores as well as wound hyperalgesia index with addition of clonidine to TAP block.…”

Section: Discussionmentioning

confidence: 99%

“…Sedation was assessed using a four point scale (1 = wide awake, 2 = awake but drowsy, responding to verbal commands, 3 = arousable, responding to physical stimulus, 4 = not arousable, not responding to verbal stimulus). [ 3 ] Any patient with score more than 1 at any point was considered sedated. Patient satisfaction was noted on a VAS (1 = extremely satisfies, 2 = satisfied, 3 = dissatisfied, 4 = extremely dissatisfied).…”

Section: Aterials and M Ethodsmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of Clonidine with Bupivaicaine vs Plain Bupivaicaine in Transversus Abdominis Plane (TAP) Block in Women Undergoing Cesarean Delivery Under Spinal Anesthesia: Randomized Clinical Trial

Kaushal

Thakur

Sharma

et al. 2023

Journal of Pharmacy and Bioallied Sciences

View full text Add to dashboard Cite

Introduction: Transversus abdominis plane (TAP) block is a technique of regional anesthesia, introduced by Rafi in 2001. Various additives have been added to prolong the duration of effect of TAP block. We conducted this study to see if addition of clonidine to bupivacaine significantly increases the duration of effect of TAP block. Materials and Methods: This randomized, parallel group, placebo controlled double blind clinical trial was conducted on 100 healthy participants (ASAII) undergoing LSCS under Spinal anesthesia (SA) from Jan 2021 to July 2021 after consent of Institutional Ethics Committee. Women with contraindications to spinal anesthesia, allergy to any of the drugs or not-suitable for cesarean under SA were excluded. After written informed consent, eligible participants were randomly allocated into two groups using computer generated random number tables using serially numbered opaque sealed envelopes. 48 out of 50 participants in group A (Bupivacaine) were given TAP block with 20 ml of 0.25% bupivacaine bilaterally. 2 women were excluded because of conversion to General Anesthesia. Similarly, 47 out of 50 participants in Group B (Bupivacaine + Clonidine) were given TAP block with 20 ml of 0.25% bupivacaine plus 1.0 mcg/kg clonidine bilaterally after completion of surgery using 18 G Tuohy needle. Separate person used to fill the drugs for block. Participants were assessed for duration of analgesic effect of TAP block measured as the time to request for additional analgesia. Additional analgesic requirement was noted. Participants were assessed for side effects of clonidine like hypotension, bradycardia, sedation and dryness of mouth. Overall patient satisfaction was also noted. Data was analysed using Graphpad Prism 9, using Student’s t-test for primary outcome and Mann–Whitney U test for secondary outcomes. Results: The mean ‘duration of analgesic effect with TAP block’ was 6.34 (SD1.26) hrs for ‘Bupivacaine’ group and 10.56 (SD2.12) hrs for ‘Bupivacaine + Clonidine’ group. None of the patients developed hypotension or bradycardia. 25% participants in Bupivacaine only group and 40.42% in Bupivacaine + Clonidine group were sedated (P < 0.05). 20.8% in ‘Bupivacaine’ group and 51.06% in ‘Bupivacaine + Clonidine’ group had dryness of mouth (P < 0.001). Patient satisfaction was equal in both the groups. Conclusion: Addition of clonidine to bupivacaine in the dose of 1 mcg/kg significantly increases the duration of analgesic effect of TAP block, decreases analgesic usage without significant increase in side effects.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Aterials and M Ethodsmentioning

confidence: 99%

Comparison of Clonidine with Bupivaicaine vs Plain Bupivaicaine in Transversus Abdominis Plane (TAP) Block in Women Undergoing Cesarean Delivery Under Spinal Anesthesia: Randomized Clinical Trial

Kaushal

Thakur

Sharma

et al. 2023

Journal of Pharmacy and Bioallied Sciences

View full text Add to dashboard Cite

show abstract

“…Beneficial effects of the addition of adjuvants to local anaesthetics in TAP block include prolonged analgesia, decreased consumption of rescue analgesics and minimal side effects. A number of studies conducted show the beneficial effects of the addition of adjuvants like dexmedetomidine, clonidine, dexamethasone, magnesium sulphate and adenosine;[ 2 - 4 , 7 - 10 ]…”

Section: Discussionmentioning

confidence: 99%

“…A number of adjuvants have been used with local anaesthetics, like dexamethasone, magnesium sulphate (MgSO 4 ), adenosine, buprenorphine and dexmedetomidine in TAP block to prolong the analgesic action in lower abdominal surgeries with varying results. [ 2 - 4 ]…”

Section: Introductionmentioning

confidence: 99%

Comparative evaluation of bupivacaine with magnesium sulphate and dexamethasone as adjuvants in ultrasound-guided transversus abdominis plane block for open unilateral inguinal hernia surgeries: A randomised controlled trial

Padhi¹,

Shambhavi²,

Das³

et al. 2023

Indian Journal of Anaesthesia

View full text Add to dashboard Cite

Background and Aims: Inguinal hernia repair is associated with moderate to severe pain that is most extreme in the first 24 hours. The aim of this study was to compare the efficacy of dexamethasone versus magnesium sulphate (MgSO 4 ) with bupivacaine in ultrasound-guided transversus abdominis plane (TAP) block for patients undergoing unilateral inguinal hernioplasty. Methods: Eighty patients were randomly allocated to two groups to receive ultrasound-guided TAP block postoperatively with either 20 ml of 0.25% bupivacaine with 8 mg of dexamethasone (Group BD) or 20 ml of 0.25% bupivacaine with 250 mg of MgSO 4 (Group BM). Patients were assessed for the first 24 hours after surgery for pain at rest and movement using a numerical rating scale (NRS). Two mg/kg of tramadol was administered as rescue analgesia. The time to first demand tramadol, total consumption of tramadol, patient satisfaction score and side effects were evaluated. Results: The time to the first dose of rescue analgesia was significantly longer in BD group (596.13 ± 57.93 min) than in the BM group (422.50 ± 51.95 min). The NRS scores in the BD group were significantly lower compared to the BM group both at rest and on movement. The total requirement of tramadol was significantly less in the BD group (154.55 ± 59.11 mg) compared to the BM group (270.25 ± 105.72 mg). The incidence of side effects was lower and patient satisfaction was higher in BD group compared to BM group. Conclusion: Bupivacaine with dexamethasone in TAP block after unilateral open inguinal hernioplasty provides increased duration of analgesia and decreased requirement for rescue analgesics compared to magnesium sulphate, with lesser side effects and better patient satisfaction.

show abstract

“…Clonidine, alpha 2 adrenoreceptor agonist, has been very commonly used as an adjuvant with LA for epidural anesthesia,[ 8 9 ] peripheral nerve blocks,[ 6 10 ] abdominal plane block,[ 11 12 ] and local infiltration. [ 13 ] Clonidine acts by binding to presynaptic C fiber and post synaptic dorsal horn neurons and shows analgesics action by depressing the release of c-fibers, transmitter, and hyperpolarizing post synaptic dorsal horn; thus, significantly prolonging the sensory and motor block.…”

Section: Discussionmentioning

confidence: 99%

Analgesic efficacy of Clonidine as an adjuvant in ultrasound-guided rectus sheath block for midline incisional hernia repair – A randomized double-blind controlled trial

Chilkoti

Maurya

Mohta

et al. 2022

Journal of Anaesthesiology Clinical Pharmacology

View full text Add to dashboard Cite

Background and Aims: Clonidine as an adjuvant has not been evaluated in rectus sheath block (RSB) for postoperative pain management in incisional hernia repair. The study aims to evaluate clonidine as an adjuvant in single-shot RSB along with general anesthesia (GA). Material and Methods: This randomized, double-blind controlled study was conducted following IEC-Human approval and written informed consent from 30 patients of either sex, aged 16 to 60 years, ASA physical status I or II undergoing midline incisional hernia repair under GA. All patients received ultrasound-guided bilateral RSB following administration of GA. The subjects enrolled in the study were randomly allocated to receive either normal saline 1 mL (group B) or clonidine 1 μg/kg diluted to 1 mL with normal saline (group BC) as adjuvant along with 9 mL bupivacaine hydrochloride 0.25%. Inj. tramadol 1 mg/kg was administered for rescue analgesia. The primary outcome was the time to first request for analgesia, and secondary outcomes were total consumption of rescue analgesic over 24 h, numerical rating score (NRS), patients’ satisfaction, hemodynamics, and side effects. Unpaired t-test and Chi-square test were used. Results: On intergroup analysis, the mean time to first request for analgesia (in min) was significantly higher in group BC i.e., [9.60 (± 5.23) vs 5.33 (± 3.53); ( P < 0.034]; whereas, the mean rescue analgesic consumption in 24 h (in mg) was higher in group B i.e., [(88.00 ± 60.97) vs (46.00 ± 48.08)]; ( P < 0.045)]. Hemodynamic parameters i.e., mean blood pressure and heart rate were comparable between the two groups, and there were no side effects. Conclusion: Clonidine as an adjuvant in single-shot ultasonography (USG)-guided RSB along with GA is efficacious for postoperative pain management following midline incisional hernia repair.

show abstract

Comparative analysis of duration of postoperative analgesia between levobupivacaine and levobupivacaine with clonidine after ultrasound-guided transversus abdominis plane block in patients undergoing lower segment cesarean section

Cited by 13 publications

References 33 publications

Comparison of Clonidine with Bupivaicaine vs Plain Bupivaicaine in Transversus Abdominis Plane (TAP) Block in Women Undergoing Cesarean Delivery Under Spinal Anesthesia: Randomized Clinical Trial

Comparison of Clonidine with Bupivaicaine vs Plain Bupivaicaine in Transversus Abdominis Plane (TAP) Block in Women Undergoing Cesarean Delivery Under Spinal Anesthesia: Randomized Clinical Trial

Comparative evaluation of bupivacaine with magnesium sulphate and dexamethasone as adjuvants in ultrasound-guided transversus abdominis plane block for open unilateral inguinal hernia surgeries: A randomised controlled trial

Analgesic efficacy of Clonidine as an adjuvant in ultrasound-guided rectus sheath block for midline incisional hernia repair – A randomized double-blind controlled trial

Contact Info

Product

Resources

About