The Efficacy and Safety of Epidural Infusions of Levobupivacaine With and Without Clonidine for Postoperative Pain Relief in Patients Undergoing Total Hip Replacement

Milligan, K. R.; Convery, P. N.; Weir, Patricia; Quinn, Patricia; Connolly, Denis

doi:10.1097/00000539-200008000-00030

Cited by 46 publications

(27 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…11 In this study both the groups were comparable with regard to age, duration of surgery. Clonidine combined with levobupivacaine has a faster onset of sensory and motor block which was in accordance with Milligan KR et al 12 , Gupta S et al 13 and Jain A et al 14 Clonidine being a lipophilic drug is rapidly absorbed into the spinal compartment and blocks the conduction of C and Aδ fibres. 15 Chalkiadis DS et al 16 in their study demonstrated the absorption characteristics of epidural levobupivacaine with clonidine and adrenaline via caudal epidural route and showed that clonidine mixed with levobupivacaine had a faster absorption compared to adrenaline mixed with levobupivacaine.…”

Section: Discussionsupporting

confidence: 79%

See 1 more Smart Citation

Epidural levobupivacaine with clonidine prolongs anaesthesia and analgesia

Arumugam

Tandon

Choudhary

2016

Sri Lankan J Anaesthesiol

View full text Add to dashboard Cite

Background: Epidural anaesthesia is a safe alternative for general anaesthesia in patients undergoing infraumbilical surgeries. This study was conducted to evaluate the effect of clonidine as an adjuvant to levobupivacaine, an S (-) enantiomer of bupivacaine. Material and Methods:Hundred patients of ASA grade I and II undergoing infraumbilical surgeries were randomized in two groups as L and LC. Group L received 0.5% levobupivacaine (1.5mg/kg) and group LC received 0.5% levobupivacaine (1.5mg/kg) with clonidine (2µg/kg). The onset time for sensory, motor blockade, duration of anaesthesia and duration of analgesia, VAS score were observed in both the groups. The haemodynamic variables such as heart rate, systolic and diastolic blood pressure, respiratory rate and SPO2 at various time intervals were measured. Any untoward side effects were noted in both groups. Results:The onset of sensory (7.8±1.7mins) and motor blockade (10.9±1.9mins) was significantly faster in clonidine group. Duration of anaesthesia and duration of analgesia was prolonged in group LC (234.5±16.1mins, 412.8±48.3mins) compared to group L (173.56±12.78 min, 269.2±24.2mins) which was statistically significant (p<0.05). Similarly clonidine group had less VAS score compared to control group. There was no significant change in the haemodynamic variables between the two groups. Hypotension and bradycardia was found more in clonidine group compared to the control group. Conclusion:Clonidine as an adjuvant to levobupivacaine prolongs the post-operative analgesia and the duration of anaesthesia for infraumbilical surgeries.

show abstract

Section: Discussionsupporting

confidence: 79%

“…Alves TCA and BrazJRC 17 also showed a significant lower VAS score compared to the control group. However Milligan Kr et al 12 demonstrated a lower VAS score in levobupivacaine with clonidine group but it was not statistically significant compared to the levobupivacaine only group.…”

mentioning

confidence: 90%

Epidural levobupivacaine with clonidine prolongs anaesthesia and analgesia

Arumugam

Tandon

Choudhary

2016

Sri Lankan J Anaesthesiol

View full text Add to dashboard Cite

show abstract

“…Blood pressure was significantly lower in the clonidine group over time but without clinical consequence. [11] Milligan et al opined that, in patients undergoing total hip replacement, the addition of the alpha(2)-adrenergic agonist clonidine to epidural infusions of levobupivacaine significantly improved postoperative analgesia [12] .…”

Section: Discussionmentioning

confidence: 99%

A Study of Clonidine and Dexmedetomidine as Adjuvant to Epidural Levobupivacaine for Post Operative Analgesia in Infraumbilical Surgeries

Acharya¹

2017

jmscr

View full text Add to dashboard Cite

“…16 The quality of pain relief from low-dose epidural infusions of plain local anaesthetic consistently benefits from the addition of adjuvants such as opioids (Hubler et al, 2001, 25 Senard et al 2002 23 ) or alpha-2 adrenoceptor agonists. Potential dose-sparing benefits are more obvious for local anaesthetic side effects (hypotension and motor block) than for opioid-related side effects.…”

Section: Postoperative Analgesiamentioning

confidence: 99%

A clinical comparative study of 0.2% levobupivacaine with 25 mcg fentanyl versus 0.2% ropivacaine with 25 mcg fentanyl for post-operative epidural analgesia in patients undergoing lower limb orthopaedic surgeries

Boregowda¹,

Linganna²,

Raju³

2020

IJCA

View full text Add to dashboard Cite

A clinical comparative study of 0.2% levobupivacaine with 25 mcg fentanyl versus 0.2% ropivacaine with 25 mcg fentanyl for post-operative epidural analgesia in patients undergoing lower limb orthopaedic surgeries Abstract Objectives: The objectives of our study were to compare the efficacy and safety of 0.2% Levobupivacaine with 25 mcg Fentanyl and 0.2% Ropivacaine with 25 mcg Fentanyl given epidurally for post-operative analgesia in patients who were operated electively for lower limb orthopaedic conditions under spinal anaesthesia. Materials and Methods:Sixty patients belonging to American Society of Anaesthesiologists (ASA) Class I and II of both sexes, of age within 20 -60 years were included in the study after obtaining institutional ethical committee clearance. Patients were divided randomly into 2 groups: Group -LF which received 8 ml of 0.2% Levobupivacaine with 25 mcg Fentanyl and Group -RF which received 8 ml of 0.2% Ropivacaine with 25 mcg Fentanyl. Surgery was conducted under spinal anaesthesia. Later 8 ml of the test drug combination was given epidurally in the post-operative period when the patient complained of pain (VAS score > 4) and the parameters were recorded periodically until pain reappeared (VAS score > 4). Results:In both the groups mean duration of surgery, changes in haemodynamics and demographic profiles were comparable. However the total duration of post-operative analgesia in Levobupivacaine group was 325 +/-63.06 minutes and in Ropivacaine group was 210 +/-24.91 minutes respectively and this appeared to be statistically significant. Conclusion: Compared to 0.2% Ropivacine with 25 mcg Fentanyl, 0.2% Levobupivacaine with 25 mcg Fentanyl provides intense and longer duration of post-operative analgesia with similar haemodynamic stability.

show abstract

The Efficacy and Safety of Epidural Infusions of Levobupivacaine With and Without Clonidine for Postoperative Pain Relief in Patients Undergoing Total Hip Replacement

Abstract: In patients undergoing total hip replacement, the addition of the alpha(2)-adrenergic agonist clonidine to epidural infusions of levobupivacaine significantly improved postoperative analgesia.

Cited by 46 publications

References 6 publications

Epidural levobupivacaine with clonidine prolongs anaesthesia and analgesia

Epidural levobupivacaine with clonidine prolongs anaesthesia and analgesia

A Study of Clonidine and Dexmedetomidine as Adjuvant to Epidural Levobupivacaine for Post Operative Analgesia in Infraumbilical Surgeries

A clinical comparative study of 0.2% levobupivacaine with 25 mcg fentanyl versus 0.2% ropivacaine with 25 mcg fentanyl for post-operative epidural analgesia in patients undergoing lower limb orthopaedic surgeries

Contact Info

Product

Resources

About