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Comparison of Fentanyl and Clonidine as an Adjuvant to Isobaric Chloroprocaine in Spinal Anaesthesia for Lower Abdominal and Limb Surgeries
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| Author:
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, REWA H SHINDE, VITHAL K DHULKHED
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| Abstract:
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Background: An alternative to bupivacaine, chloroprocaine has been evaluated for spinal anesthesia in the subarachnoid space. Addition of adjuvants, such as clonidine and fentanyl can potentiate the effect of subarachnoid block and prolong postoperative analgesia. Limited research has evaluated adjuvants individually, such as fentanyl and clonidine with chloroprocaine. Thus, there is a lacunae in literature on comparative evaluation of clonidine and fentanyl with chloroprocaine.
Aim: To compare the effect of intrathecal clonidine and fentanyl as an adjuvant to isobaric chloroprocaine in spinal anaesthesia for lower abdominal and limb surgeries lasting less than 90 min.
Methods: A total of 60 patients aged 19-60 years, with ASA status I and II, scheduled for lower abdominal and limb surgeries were randomly allocated to Group F (n=30; 1% isobaric chloroprocaine 25 mg and fentanyl 25 µg) and Group C (n=30; 1% isobaric chloroprocaine 25 mg and clonidine 35 µg). Sensory and motor block characteristics, duration of postoperative analgesia, hemodynamic variations, and side effects were noted and analyzed by Software R version 3.6.0.
Results: Onset and duration of sensory block was significantly lower in Group F (8.54±1.5 min and 62±19.7 min) than Group C (9.67±3.9 min and 78.9±28.8 min), respectively. Group F had significantly higher post-op analgesia compared to Group C (101±18.9 and 92.8±27.8; P=0.086, respectively). Duration of motor block in Groups F and C were 78.2±14.7 min and 80.6±24.1 min, respectively (P=0.391). Significant variation in heart rate were observed till 90 min post-operatively (P<0.05), whereas significant variation in mean arterial pressure observed till 10 min post-operatively (P <0.0001). Hypotension and bradycardia were significantly higher in Group C (20% and 6.7%) than Group F (10% and 3.3.%; P=0.01), while pruritis was observed only in group F (23.3%).
Conclusion: Low dose 1% chloroprocaine (25 mg) with fentanyl provide adequate sensory and motor block for brief surgical produces with minimal side effects.
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| Keyword:
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Analgesia, intrathecal, local anesthetics, bupivacaine
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| EOI:
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-
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| DOI:
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https://doi.org/10.31838/ijpr/2020.12.03.398
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| Download:
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