Comparative Study Between Levobupivacaine With Clonidine and Ropivacaine With Clonidine in Thoracic Epidural Block for Laparoscopic Cholecystectomy

Abstract

INTRODUCTION:Laparoscopic cholecystectomy has traditionally been performed under general anesthesia, however, with the development and advancement of newer surgical and anesthetic techniques, approaches using regional anaesthesia are emerging as a viable and useful alternative. This study was conducted to compare the postoperative analgesic efficacy and safety of levobupivacaine with clonidine and ropivacaine with clonidine. MATERIAL AND METHODS: A randomized single-blind controlled trial was done with 60 patients of American Society of Anesthesiologists Grade I or II status undergoing laparoscopic cholecystectomy. Group I (N = 30) (patients n = 30) received epidural anesthesia 0.5% (2 mg/kg) levobupivacaine with 1.2 µg/kg clonidine. Whereas group II (N=30) received epidural anesthesia 0.75% (3 mg/kg) ropivacaine with 1.2 µg/kg clonidine.. Vital parameters were recorded. RESULTS: In both the groups, throughout the procedure, mean heart rate and blood pressure levels were either significantly lower or comparable to the baseline levels. In both the groups most of the times hypotensive effect of anaesthetic agents was observed. CONCLUSION: Levobupivacaine with clonidine provided an early and longer block and showed lesser analgesic need for shoulder pain as compared to ropivacaine with clonidine yet both the groups showed a high decline in blood pressure that necessitated the vasopressor use.

A Comparative Study of Levobupivacaine With Clonidine and Levobupivacaine With Dexmedetomidine in Thoracic Epidural Block for Laparoscopic Cholecystectomy

“…[5][6][7][8] Mean onset time of sensory block was 8.82±2.74 minutes and mean duration of sensory block was 4.87+0.79 hours in Group 1. [9] Mean onset time of sensory block was 8.45+2.56 minutes and mean duration of sensory block was 5.74+1.53 hours in Group 2, Kamal et al studied levobupivacaine with dexmedetomidine for thoracic epidural anaesthesia for major abdominal surgeries found that mean onset of sensory block as 12.6+5.9 minutes and mean regression time of sensory block was 390+87.6 mins, which was different from our study. This may be due to different doses of the drugs.…”

Terapêutica anestésica para o alívio da dor aguda pós-colecistectomia videolaparoscópica: revisão sistemática.

“…This block showed lower postoperative pain and opioid need scores in comparison to the posterior TAP block or no blockade 35 . When two groups undergoing epidural block were compared in a LC surgery, the associated use of clonidine with levobupivacaine resulted in less analgesic need in the treatment of shoulder pain compared with clonidine with ropivacaine, but both groups had a high decline in blood pressure, requiring vasopressors 34 .…”