RESUMO
Ropivacaine is a novel alternative to bupivacaine with the less cardiovascular system and central nervous system toxicity. Clonidine, an alpha 2 agonist, may have benefited patients when it is injected at peripheral nerve sites with local anesthetic ropivacaine. Clonidine is second only to epinephrine as a useful adjuvant for brachial plexus blockade. A clinical study was carried out to compare the anesthetic effects of ropivacaine alone and clonidine as an adjuvant to ropivacaine in brachial plexus block for upper limb surgeries. A comparative, double-blind, prospective, randomized, clinical study was carried out on 60 patients of either sex of American Society of Anesthesiologist physical status I and II, with age group 25-65 years undergoing various orthopedic surgeries of upper limb under supraclavicular brachial plexus block. Patients were randomly allocated to either of the two groups of 30 each. Group-R: Injection ropivacaine 30 ml [0.75%] with 1 ml normal saline. Group-ropivacaine clonidine [RC]: linjection ropivacaine 30 ml [0.75%] with injection clonidine 1 ml [150 microg]. Heart rate, mean arterial pressure, onset and duration of motor and sensory blockade were observed during preoperative, intraoperative and postoperative period. At the end of the study, the data were analyzed using Chi-square test for qualitative data and Student t-test. P < 0.05 was considered significant and P < 0.01 was considered as highly significant. Demographic and hemodynamic data were comparable. Onset of sensory and motor block was significantly earlier in Group-R. Duration of analgesia and motor blockade was prolonged in the RC group. Both groups were observed for the side-effects, which were not significant. Addition of clonidine 150 microm to ropivacaine 0.75% 30 ml delays the onset of sensory and motor blockade while prolongs the postoperative motor blockade and analgesia significantly without producing any clinical significant side-effects in brachial plexus block through supraclavicular approach
RESUMO
To compare the effectiveness of single bolus dose of esmolol or fentanyl in attenuating the hemodynamic responses during laryngoscopy and endotracheal intubation. Ninety adult ASA I and ASA II patients were included in the study who underwent elective surgical procedures. Patients were divided into three groups. Group C [control] receiving 10 ml normal saline, group E [esmolol] receiving bolus dose of esmolol 2 mg/kg and group F [fentanyl] receiving bolus dose of fentanyl 2microg/kg intravenously slowly. Study drug was injected 3 min before induction of anesthesia. Heart rate, systemic arterial pressure and ECG were recorded as baseline and after administration of study drug at intubation and 15 min thereafter. Reading of heart rate, blood pressure and rate pressure product were compared with baseline and among each group. The rise in heart rate was minimal in esmolol group and was highly significant. Also the rate pressure product at the time of intubation was minimal and was statistically significant rate 15 min thereafter in group E. Esmolol 2 mg/kg as a bolus done proved to be effective in attenuating rises in heart rate following laryngoscopy and intubation while the rise in blood pressure was suppressed but not abolished by bolus dose of esmolol