Research article
Comparison of clonidine and fentanyl as an adjuvant to intrathecal bupivacaine for spinal anaesthesia and postoperative analgesia in patients undergoing caesarian section
Authors:
Ramchandra Vinayak Shidhaye ,
IN
About Ramchandra
Professor
Department of Anaesthesiology and Critical Care
Pravara Institute of Medical Sciences, Loni 413736
Bhavini Bhushan Shah,
IN
About Bhavini
Assistant Professor
Department of Anaesthesiology and Critical Care
Dr. D.Y. Patil Medical College Pimpri, Pune 411018
Smita Suresh Joshi,
IN
About Smita
Professor
Department of Anaesthesiology and Critical Care
Dr. D.Y. Patil Medical College Pimpri, Pune 411018
Shrikrishna Govind Deogaonkar,
IN
About Shrikrishna
Associate Professor
Department of Anaesthesiology and Critical Care
Pravara Institute of Medical Sciences, Loni 413736
Abhishek P Bhuva
IN
About Abhishek
Resident
Department of Anaesthesiology and Critical Care
Pravara Institute of Medical Sciences, Loni 413736
Abstract
Background Fentanyl and clonidine both prolong sensory and motor block of spinal anaesthesia and duration of postoperative analgesia when used as an adjuvant to intrathecal bupivacaine. Lack of studies that directly compare them regarding their efficacy prompted us to compare both drugs as an adjuvant to intrathecal bupivacaine for spinal anaesthesia and postoperative analgesia in patients undergoing caesarian section.
Methods and Material In a prospective, randomized, study forty parturients between 18 to 35 years of age, of ASA grade I or II, awaiting caesarian section were randomly distributed into two equal groups. Patients were given 2.0 ml of hyperbaric bupivacaine 0.5% with either 60μg of clonidine or 25μg of fentanyl intrathecally. Duration of effective analgesia (primary outcome measure), onset peak and duration of sensory and motor blockade, level of sedation, maternal haemodynamic parameters and foetal parameters (secondary outcome measures)were compared.
Results Both groups were comparable with respect to demographic profile, onset, peak and duration of sensory and motor block and overall haemodynamic stability. Duration of analgesia was significantly higher in bupivacaine with clonidine 60μg group (BC60 group) than in bupivacaine with fentanyl 25μg group (BF25 group). Sedation was more prevalent in BC60 group.
Conclusion Intrathecal addition of 25μg fentanyl to bupivacaine provides good analgesia with less sedation and is a better option when sedation is not desirable. However intrathecal addition of 60μg clonidine to bupivacaine provides longer duration of postoperative analgesia than 25μg of fentanyl and is a preferred option when sedation is acceptable or required.
DOI: http://dx.doi.org/10.4038/slja.v22i1.6158
How to Cite:
Shidhaye, R.V., Shah, B.B., Joshi, S.S., Deogaonkar, S.G. and Bhuva, A.P., 2013. Comparison of clonidine and fentanyl as an adjuvant to intrathecal bupivacaine for spinal anaesthesia and postoperative analgesia in patients undergoing caesarian section. Sri Lankan Journal of Anaesthesiology, 22(1), pp.15–20. DOI: http://doi.org/10.4038/slja.v22i1.6158
Published on
22 Dec 2013.
Peer Reviewed
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