Effect of Oral Clonidine, Etoricoxib, and Gabapentin as Premedication on Sensory and Motor Blocks and Post Operative Analgesia in Surgeries Under Subarachnoid Block Using Bupivacaine

Tiwari, Akhilesh Kumar; Tayal, Swapnil; Chadha, Madhur; Ganguly, Subroto; Mandhyan, Rajani

doi:10.1097/mjt.0b013e318249a1a0

Cited by 4 publications

(3 citation statements)

References 15 publications

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“…. We excluded one duplicate trial , three trials that were unavailable as full text , five trials that did not use a placebo , one trial that used combination therapy and two uncontrolled trials .…”

Section: Resultsmentioning

confidence: 99%

A systematic review and meta‐regression analysis of prophylactic gabapentin for postoperative pain

et al. 2015

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SummaryWe searched MEDLINE, Embase, CINAHL, AMED and CENTRAL databases until December 2014 and included 133 randomised controlled trials of peri-operative gabapentin vs placebo. Gabapentin reduced mean (95% CI) 24-h morphine-equivalent consumption by 8.44 (7.26-9.62) mg, p < 0.001, whereas more specific reductions in morphine equivalents were predicted (R 2 = 90%, p < 0.001) by the meta-regression equation: 3.73 + (À0.378 9 control morphine consumption (mg)) + (À0.0023 9 gabapentin dose (mg)) + (À1.917 9 anaesthetic type), where 'anaesthetic type' is '1' for general anaesthesia and '0' for spinal anaesthesia. The type of surgery was not independently associated with gabapentin effect. Gabapentin reduced postoperative pain scores on a 10-point scale at 1 h, 2 h, 6 h, 12 h and 24 h by a mean (95% CI) of: 1.68 (1.35-2.01); 1.21 (0.88-1.55); 1.28 (0.98-1.57); 1.12 (0.91-1.33); and 0.71 (0.56-0.87), respectively, p < 0.001 for all. The risk ratios (95% CI) for postoperative nausea, vomiting, pruritus and sedation with gabapentin were: 0.78 (0.69-0.87), 0.67 (0.59-0.76), 0.64 (0.51-0.80) and 1.18 (1.09-1.28), respectively, p < 0.001 for all. Gabapentin reduced pre-operative anxiety and increased patient satisfaction on a 10-point scale by a mean (95% CI) of 1.52 (0.78-2.26) points and 0.89 (0.22-1.57) points, p < 0.001 and p = 0.01, respectively. All the effects of gabapentin may have been overestimated by statistically significant small study effects.

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Section: Resultsmentioning

confidence: 99%

A systematic review and meta‐regression analysis of prophylactic gabapentin for postoperative pain

et al. 2015

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“…Preemptive analgesia, considered capable of preventing peripheral and central sensitization [ 8 ], is also a viable option. Corticosteroids and non-steroidal anti-inflammatory drugs (NSAIDs) are the most commonly used analgesic and anti-inflammatory drugs [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Comparing pre- and postoperative etoricoxib administration versus only postoperative on third molar extraction sequelae and oral health quality of life: a prospective quasi-experimental study

La Rosa,

Consoli,

Abiad

et al. 2024

Clin Oral Invest

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Objectives This study aimed to compare the impact of pre- and postoperative etoricoxib administration versus only postoperative on third molar extraction sequelae and oral health quality of life. Materials and methods This prospective quasi experimental study involved 56 patients, divided into a study group receiving preemptive etoricoxib 120 mg before surgery and postoperative etoricoxib 120 mg (n = 28), and a control group receiving preemptive placebo before surgery and postoperative etoricoxib 120 mg (n = 28). Follow-up assessments were conducted at 3- and 7-days post-surgery, recording swelling, trismus, and adverse events. Patients rated perceived pain using the visual analog scale (VAS) and completed an oral health-related quality of life (OHRQoL) questionnaire at specified intervals. Statistical analysis employed non-parametric tests (i.e., the Mann–Whitney test, Friedman test, and Wilcoxon sign test) with P < 0.05. Results Significantly lower VAS scores were reported in the study group throughout the follow-up period (P < 0.05). Pharmacological protocol did not have a significant impact on postoperative edema and trismus (P > 0.05). However, double etoricoxib intake significantly improved postoperative quality of life on day 3 after surgery (P < 0.05). Conclusions Pre- and postoperative etoricoxib 120 mg intake in third molar surgery reduced postoperative pain and enhanced postoperative quality of life on day 3 after surgery. Importantly, it was equally effective in managing swelling and trismus compared to exclusive postoperative intake. Clinical Relevance Preemptive etoricoxib use may decrease patient discomfort following impacted mandibular third molar extraction.

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“…Oral clonidine premedication is convenient and has additional benefit of subsiding anxiety as well as potentiating the anesthetic effect of spinal bupivacaine apart from enhancing its analgesic action. [ 4 5 6 7 8 ] Researchers say that oral route is preferred over other routes as it has a better compliance owing to avoidance of a potential needle prick. Evaluation of intramuscular route of clonidine for postoperative analgesic efficacy has been done in only a limited number of studies.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Oral versus Intramuscular Clonidine for Prolongation of Bupivacaine Spinal Anesthesia in Patients Undergoing Total Abdominal Hysterectomy

Mishra

Gogia

Singh

et al. 2021

Anesthesia Essays &Amp; Researches

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Background: Clonidine is a commonly used agent for premedication through oral, intravenous, and intramuscular route. Very few studies mentioned intramuscular clonidine as premedication. Aims and Objectives: The aim of the present study is to compare oral and intramuscular clonidine as predication agent in bupivacaine spinal anesthesia patients. Materials and Methods: In our study, recruited patients were randomly allocated in three groups of 32 each. All patients received intrathecal bupivacaine heavy 3 mL with oral 150 μg clonidine in Group 1, intramuscular 150 μg clonidine in Group 2, and oral placebo tablet in Group 3 1 h before taking the patient in operation theater. We have assessed for duration of sensory block, duration of motor block, duration of analgesia, sedation score, and hemodynamic changes in groups. Statistical Analysis: The parametric data were expressed as mean ± standard deviation. Primary analysis of parametric data between the two groups was done by student's t -test, and among three groups, analysis of variance was used. Results: Duration of motor block was found significantly high in Group 2 than Group 1 (208.06 ± 9.48 vs. 200.25 ± 9.42; P < 0.05). Duration of sensory block was also found significantly high in Group 2 than Group 1 (219.69 ± 9.44 vs. 210.25 ± 9.68; P < 0.05). Time to give first dose of analgesia was also found greater in Group 2 than Group 1 (234.66 ± 11.76 vs. 217.75 ± 10.09; P < 0.05). Sedation score and other side effects were found statistically nonsignificant between Group 1 and 2. Conclusion: We can conclude that preoperative intramuscular clonidine is a better alternate of oral clonidine for bupivacaine spinal anesthesia in terms of long duration of motor and sensory block and less requirement of analgesic with clinically insignificant side effects.

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Effect of Oral Clonidine, Etoricoxib, and Gabapentin as Premedication on Sensory and Motor Blocks and Post Operative Analgesia in Surgeries Under Subarachnoid Block Using Bupivacaine

Cited by 4 publications

References 15 publications

A systematic review and meta‐regression analysis of prophylactic gabapentin for postoperative pain

A systematic review and meta‐regression analysis of prophylactic gabapentin for postoperative pain

Comparing pre- and postoperative etoricoxib administration versus only postoperative on third molar extraction sequelae and oral health quality of life: a prospective quasi-experimental study

Comparison of Oral versus Intramuscular Clonidine for Prolongation of Bupivacaine Spinal Anesthesia in Patients Undergoing Total Abdominal Hysterectomy

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