RESUMEN
Addition of clonidine to local anesthetics improves peripheral nerve blocks by reducing the onset time, improving the efficacy and extending postoperative analgesia. This study evaluated the effect of Bupivacaine clonidine combination in supraclavicular brachial plexus block for upper limb surgeries. A randomized double-blind controlled trial was performed in 60 patients. Group B (n=30) patients received 25 mL 0.5% Bupivacaine and 0.2 mL of Saline, whereas group C (n = 30) received 25 mL 0.5% bupivacaine and 0.2 mL (30 mcg) clonidine through supraclavicular brachial plexus block. In both groups, differences between age, sex, ASA grades, weight, vital parameters were statistically insignificant. Time of onset of sensory blockade and motor blockade were reduced in group C compared to Group B and were statistically significant. Duration of sensory and motor blockade were prolonged in group C compared to Group B and were statistically significant. Duration of post operative analgesia was prolonged in group C compared to Group B and were statistically significant. Sedation score of patients in group C were higher than those in group C intra-operatively and postoperatively. No clinically significant differences were observed in pulse rate, mean blood pressure and oxygen saturation. Due to its sedative properties, it can reduce patient anxiety and provide optimal intra-operative and postoperative patient comfort.
RESUMEN
Background: Pain is main post operative adverse outcomes causing patient distress, prolonging hospital stay, and increasing the incidence of admissions after surgery. Study was done to assess and compare the post-operative analgesic effects of fentanyl via nebulisation, intranasal and intravenous routes to provide better analgesia, anxiolysis and sedation to the patient. Materials and methods: After approval from ethical committee of SPMC, Bikaner and written informed valid consent from patients, sixty patients of either sex belonging to ASA class I and II, were randomised into three group (Group I - Nebulised Fentanyl, Group II - Intranasal Fentanyl, Group III - Intravenous Fentanyl). With all aseptic precaution, subarachnoid block was instilated via 23/25 gauze spinal needle by injecting sufficient dose of bupivacaine heavy 5% to achieve an adequate sensory and motor block for the proposed surgery. When patient complained pain 1st time, fentanyl was given via nebulisation in group I, intranasal in group II, and intravenous in group III with dose 4 mcg/kg, 1.5 mcg/kg, 2 mcg/kg respectively. Patients were assessed for pain by VAS score. For statistical data, SPSS 10.0 software was used. Results: In present study, Ramsay sedation score, patient satisfaction score and duration of analgesia was better in group II as compared to group I and III. Group III had lesser time of onset of analgesia in comparison to group II and I respectively. Singh R, Pareek A, Kumari M, Khilji MY, Sirohiya P. Post-operative analgesic efficacy of fentanyl via different routes – A comparative study of nebulisation, intranasal and intravenous routes. IAIM, 2016; 3(6): 16-22. Page 17 Conclusion: On the basis of analgesic efficacy, we concluded that intranasal group was better than nebulisation and intravenous route.