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Background: Pregabalin has been used and found effective in preventing neuropathic component of acute nociceptive pain during and after surgery. We conducted a study to compare the effect of oral gabapentin and pregabalin on different block characteristics. Methods: A total of 90 ASA grade I and II patients posted for elective surgeries were randomized into 3 groups (groups A, B and C 30 patients each). One hour before entering into the operation theatre the blinded drug selected for the study was given with a sip of water. Group A – received identical placebo capsule, Group B-received 600 mg of gabapentin capsule and Group C- received 150 mg of pregabalin capsule. Spinal anaesthesia was performed at the L3-L4 interspace. 3.5 ml of 0.5% bupivacaine heavy injected over 30 sec through a 25 G spinal needle. VAS score at first rescue analgesia, mean time of onset of analgesia, level of sensory block at 5 min and 10 min interval, onset of motor block, total duration of analgesia and total requirement of rescue analgesia were observed. Hemodynamics parameters and side effects were recorded in all patients. Results: A significantly longer mean duration of effective analgesia in group C was observed compared with other groups (p<0.001). The mean duration of effective analgesia in group C was 535.16 ± 32.86 min versus 151.83 ±16. 21 minutes in group A and 302.00 ± 24.26 minutes in group B. The mean numbers of doses of rescue analgesia in the first 24 hours in group A, B and C were 4.7 ± 0.65, 4.1 ± 0.66 and 3.9 ± 0.614 respectively. (P value <0.001). Conclusion: We conclude that pre-emptive use of gabapentin 600mg and pregabalin 150 mg orally significantly reduces the postoperative rescue analgesic requirement and increases the duration of postoperative analgesia in patients undergoing elective surgeries under spinal anaesthesia.
RESUMO
Background: The aim of this study is to compare the effects of Dexmedetomidine and Fentanyl as intrathecal adjuvant to Bupivacaine on the onset and duration of sensory and motor block in orthopaedic lower limb surgeries. Methods: Ninety patients of ASA status I and II posted for lower limb surgery were randomly divided into three groups. Group D was administered Hyperbaric Bupivacaine 15 mg + Dexmedetomidine 5μg in 0.5 ml normal saline, group F was administered Hyperbaric Bupivacaine 15 mg + Fentanyl 25 μg in 0.5 ml normal saline and group C were administered Hyperbaric Bupivacaine 15 mg plus in 0.5 ml normal saline. Duration and quality of sensory and motor block were assessed. Results: Sensory and motor block in-group D patients were longer than group F and C patients. Conclusion: Intrathecal dexmedetomidine when added to bupivacaine heavy (0.5%) provide better and prolonged analgesia in comparison to fentanyl.
RESUMO
Background: Many researchers have been done to find an ideal adjuvant to ropivacaine in regional anaesthesia that inhibits intra and post-operative pain and prolong the duration of anaesthesia without any side effects. Aim: This study was conducted to evaluate the onset, extent and duration of sensory and motor block and side effects of clonidine or dexmedetomidine when used as an adjuvant to ropivacaine in epidural anaesthesia in lower limb orthopaedic surgery. Methods: A prospective randomized study was conducted on 60 patients of American society of anaesthesiologists’ status I and II, posted for lower limb orthopaedic surgery. All patients were randomly allocated into two groups of 30 each; group I was ropivacaine - clonidine group (RC) and group II was ropivacaine - dexmedetomidine group (RD). Group I (RC) patients received 16 ml of 0.75% ropivacaine and clonidine 2 mcg/kg. Group II (RD) patients received 16 ml of 0.75% ropivacaine and dexmedetomidine 1.5 mcg/kg. The onset, extent, duration of sensory and motor blocks, and side effects were recorded. Results: Dexmedetomidine had a visible edge over clonidine as it enabled an earlier onset and longer duration of sensory and motor block. Sedation scores were statistically significant with the RD group in comparison to RC group. The RD group showed visible superiority over the RC group in various post-operative block characteristics like the weaning of sensory and motor block, prolonged post-operative analgesia. Conclusion: Dexmedetomidine was a better alternative to clonidine as an adjuvant to ropivacaine in epidural anaesthesia in orthopaedic lower limb surgeries.
RESUMO
Background: Several clinical studies have shown that clonidine prolongs sensory motor blockade when used with bupivacaine but ideal doses of clonidine on ropivacaine is not well defined and to evaluate the effect of two doses of clonidine on ropivacaine, for supraclavicular brachial plexus blockade. Methods: In a prospective randomized double blind study supraclavicular brachial plexus blockade were performed in 80 patients using 35 ml ropivacaine (0.5%). Group A (n=40) had 2 μg/kg clonidine and in Group B (n=40) 1 μg/kg clonidine added to ropivacaine. Sensory and motor blockade was assessed every 5 min till 30 min and at 15 min interval thereafter. Results: Mean sensory onset time in group A was 10.42 ± 5.5 min and in group B was 15.83 ± 6.51 min, which was statistically significant. Patients of group A had a mean motor onset time 14.35 ± 7.8 min and patients of group B had a mean motor onset time 18.53 ± 7.61 min, the difference being statistically significant. Mean duration of sensory block in group A was 484.13 ± 63.1 min and in group B was 390.83 ± 72.63 min, which was statistically significant. Patients in-group A had a mean duration of motor block 550 +60.1 min and patients in group B had a mean duration of motor block 430.43+68.5 min, which was statistically significant. Conclusion: The addition of clonidine in dose of 2 μg/kg to ropivacaine for brachial plexus blockade, increases the onset and duration of motor and sensory block significantly.