Comparative study of clonidine with ropivacaine versus ropivacaine alone in epidural anesthesia for lower limb orthopedic surgery

Abstract

Background:Epidural anesthesia has been well established as a safe and effective technique not only for perioperative anesthesia but also for postoperative analgesia. Various adjuvants have been added to local anesthetic agent in an effort to prolong this duration.Aims:The aim of this study was to compare and evaluate the anesthesia and analgesic property of ropivacaine to its combination with clonidine for lower limb orthopedic surgery under epidural.Materials and Methods:In a prospective, randomized, double-blind study, eighty adult patients undergoing lower limb surgeries received either 0.75% ropivacaine or 75 μg clonidine with 0.75% ropivacaine through epidural route. Patients were compared for hemodynamic variability, quality of motor and sensory block, intra- and post-operative analgesia, and the side effects associated.Statistical Analysis:Data analysis was done by Student's paired t-test, Chi-square test, and Mann–Whitney test. P < 0.05 was considered statistically significant.Results:The time taken for onset of the motor as well as the sensory block was significantly shorter in ropivacaine with clonidine group as compared to ropivacaine alone group. Mean duration of analgesia was significantly higher in patients who received clonidine as an adjunct (P < 0.001). There was no significant difference observed in the incidence of hemodynamic changes or side effects.Conclusion:The study demonstrated that use of clonidine as an adjuvant to ropivacaine through epidural route provides a hemodynamically stable, faster, and prolonged epidural block and a longer analgesic effect as compared to ropivacaine alone.

Comparison of Epidural Bupivacaine and Buprenorphine to Bupivacaine and Butorphanol for Postoperative Analgesia in Lower Limb Orthopedic Surgery

“…Butorphanol is a lipophilic opioid with weak μ receptor agonist and antagonist activity and potent ƙ receptor agonism. Numerous studies compared epidural local anesthetics to dexmedetomidine, fentanyl, clonidine, and morphine in lower limb orthopedic surgery ( 8 , 9 ). There is a paucity of data on comparing epidural buprenorphine and butorphanol as adjuvants to bupivacaine for postoperative analgesia in lower limb orthopedic surgery.…”