A randomised trial to compare the effect of addition of clonidine or fentanyl to hyperbaric ropivacaine for spinal anaesthesia for knee arthroscopy

Bathari, Ronald; Bhalotra, Anju; Anand, Raktima; Kumar, Vinod

doi:10.1080/22201181.2015.1089667

Cited by 4 publications

(5 citation statements)

References 21 publications

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“…In our study group total duration of analgesia was 6.92 hrs which is comparable with Wahedi w et al and Ronald bathari et al studies who administered other opioid intrathecally along with isobaric ropivacaine [13,14].…”

Section: Resultssupporting

confidence: 88%

Comparative Study of Isobaric Ropivacaine with and without Morphine in Spinal Anaesthesia for Perineal Surgeries

V.P¹,

Ramesh²,

Choudhary³

2016

IJAR

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Objectives: The comparative study is under taken to evaluate use of intrathecal isobaric ropivacaine with and without adjuvant morphine in perineal surgeries. Aims: The aim of this study is to evaluate sensory block, motor block and other clinical effects with 3 ml of isobaric 0.5% ropivacaine along with 100µ morphine and without mophine intrathecally in Perineal surgeries . Methods: This study was conducted in 100 patients scheduled for elective Perineal surgeries. The patients were grouped as study and control group with 50 patients in each group. The study group received 3ml of 0.5% isobaric ropivacaine with 100µ morphine intrathecally and control group received only 3ml of 0.5% isobaric ropivacaine. Onset and duration of sensory block, motor block, quality of anaesthesia, time of request for analgesia, time for ambulation, VAS score, hemodynamic parameters and adverse effects if any were studied. Results: In present study faster in onset of sensory block with normal duration sensory block was observed in study group. In addition short duration of motor block, with early ambulation was noted in study group. Requirement of rescue analgesia was prolonged with duration of 5.92 hrs in study group in comparison to control group which was 4.00 hrs and this was statically significant. Conclusion: Intrathecal administration of Isobaric ropivacaine with 100µ morphine provides better quality of sensory block, faster onset sensory block with shorter duration of motor block, enabling early ambulation and significantly prolonged analgesia.

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Section: Resultssupporting

confidence: 88%

Comparative Study of Isobaric Ropivacaine with and without Morphine in Spinal Anaesthesia for Perineal Surgeries

V.P¹,

Ramesh²,

Choudhary³

2016

IJAR

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“…10 Whereas, another study found a similar duration of analgesia with intrathecal fentanyl and clonidine added to hyperbaric ropivacaine, which may be due to the low dose of clonidine used by them (15 μg) as compared to us. 14 In our study, the onset of sensory and motor block was similar in both the groups, which is in concordance with the results observed by two other studies. 12,16 The duration of motor block was significantly longer in Group C (300.37 ± 48.79 min) as compared to Group F (177.75 ± 33.93 min) in our study.…”

Section: Figuresupporting

confidence: 93%

“…Most studies have used lower doses of clonidine (15, 30 or 50 μg), to avoid associated sedation and haemodynamic side effects, while we used a dose of 75 μg in our study. 10,12,14 Clonidine shows a dose-dependent increase in the duration of analgesia. A study compared three different doses of intrathecal clonidine 15 μg, 30 μg and 45 μg with isobaric ropivacaine for infraumbilical surgeries and concluded that increasing the dose of clonidine increases the quality of SAB with manageable side effects.…”

Section: Figurementioning

confidence: 99%

Comparison of Clonidine with Fentanyl as an Adjuvant to Isobaric Ropivacaine in Patients undergoing Vaginal Hysterectomy under Subarachnoid Block

Choudhary

Chaudhary

Swami

et al. 2021

Sri Lankan J Anaesthesiol

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BackgroundThe use of adjuncts to local anaesthetics improves the standard of subarachnoid block (SAB). We compared intrathecal clonidine-ropivacaine combination and fentanyl-ropivacaine combination with respect to quality and duration of sensory/motor block and associated side effects. Subjects and methods80 patients undergoing elective vaginal hysterectomy under SAB were enrolled for this hospital-based, prospective, randomized, double-blind study and divided into two groups of 40 each. As an adjuvant to 0.75% isobaric ropivacaine Group C received 75μg intrathecal clonidine (0.5 ml) while Group F was given 25μg intrathecal fentanyl (0.5 ml). The characteristics of sensory and motor block, duration of analgesia, intraoperative and postoperative Campbell sedation score, haemodynamic profile and any adverse event were recorded and analysed. Fischer exact or Chi-square test was used for the comparison of categorical data and unpaired t-test to compare the quantitative data using Statistical Packages for Social Sciences (SPSS) version 21. P value of < 0.05 was considered statistically significant. ResultsSensory and motor block duration, duration of analgesia, intraoperative and postoperative sedation score was significantly higher in Group C (P < 0.05). Systolic blood pressure, diastolic blood pressure and mean blood pressure were significantly lower in Group C as compared to Group F at various time points with a similar overall incidence of hypotension from the baseline value. ConclusionClonidine-ropivacaine combination in SAB provides a prolonged duration of sensory as well as motor block and enhances postoperative analgesia in comparison to fentanyl-ropivacaine combination with a higher degree of sedation.

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“…in their study concluded that intrathecal fentanyl 30 μg was superior to intrathecal clonidine15 μg in knee arthroscopy which was not in agreement with our study. [ 12 ] This may be due to the use of low dose of intrathecal clonidine and high dose of intrathecal fentanyl. Benhamou et al .…”

Section: Discussionmentioning

confidence: 99%

“…concluded that intrathecal fentanyl was superior to intrathecal clonidine in knee arthroscopy. [ 12 ] Hence, all the above studies differ in their postoperative sensory and motor block characteristics. Hence, the present study is being undertaken to evaluate and compare the effects of clonidine and fentanyl as intrathecal adjuvants to hyperbaric bupivacaine in patients undergoing lower limb orthopedic surgery.…”

Section: Introductionmentioning

confidence: 99%

Comparison of intrathecal clonidine and fentanyl as adjuvant to hyperbaric bupivacaine in subarachnoid block for lower limb orthopedic surgery

Routray

Raut

Pradhan³

et al. 2017

Anesth Essays Res

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Background:Many studies are there using adjuvants such as clonidine and fentanyl with bupivacaine in the subarachnoid block for prolonging postoperative analgesia. However, literature is divided regarding the dosage and efficacy of both intrathecal adjuvants. Furthermore, these adjuvants have their own side effects. Hence, search for ideal intrathecal adjuvant between clonidine and fentanyl to bupivacaine goes on.Aim:The aim of the present study was to compare the effect of intrathecal clonidine and fentanyl as adjuvant to bupivacaine in the subarachnoid block for lower limb orthopedic surgery.Materials and Methods:It was a prospective randomized study in which eighty patients posted for lower limb orthopedic surgery were divided into two groups of forty each. Group C – Received intrathecal hyperbaric bupivacaine (2.5 ml) +50 μg clonidine (diluted to 0.5 ml). Group F – Received intrathecal hyperbaric bupivacaine (2.5 ml) + fentanyl 25 μg (diluted to 0.5 ml). Duration of postoperative analgesia, sensory and motor block characteristics, hemodynamic parameters, and side effects were recorded and analyzed.Results:Time for first dose of rescue analgesic was delayed in Group C (510.84 ± 24.10 min) in comparison to Group F (434.95 ± 19.16 min) which was statistically significant (P < 0.001). Duration of sensory and motor block was significantly prolonged in Group C compared to Group F (P < 0.001). Sedation was more in Group C than Group F (P < 0.001). Other block characteristics, hemodynamic, and side effects were comparable in both groups.Conclusion:Intrathecal clonidine as adjuvant to hyperbaric bupivacaine provided prolonged postoperative analgesia with more sedation in comparison to intrathecal fentanyl.

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A randomised trial to compare the effect of addition of clonidine or fentanyl to hyperbaric ropivacaine for spinal anaesthesia for knee arthroscopy

Cited by 4 publications

References 21 publications

Comparative Study of Isobaric Ropivacaine with and without Morphine in Spinal Anaesthesia for Perineal Surgeries

Comparative Study of Isobaric Ropivacaine with and without Morphine in Spinal Anaesthesia for Perineal Surgeries

Comparison of Clonidine with Fentanyl as an Adjuvant to Isobaric Ropivacaine in Patients undergoing Vaginal Hysterectomy under Subarachnoid Block

Comparison of intrathecal clonidine and fentanyl as adjuvant to hyperbaric bupivacaine in subarachnoid block for lower limb orthopedic surgery

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