Comparison of intrathecal clonidine and fentanyl in hyperbaric bupivacaine for spinal anesthesia and postoperative analgesia in patients undergoing lower abdominal surgeries

Bajwa, Baljit Singh; Singh, Anshuman; Rekhi, Angelina K

doi:10.4103/1658-354x.197337

Cited by 17 publications

(17 citation statements)

References 15 publications

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“…Duration of analgesia was significantly prolonged in clonidine group (502.45±120.84 min) than in fentanyl group (401± 100.70 min), (P < 0.05). These results were in accordance with the study conducted by Shidhaye RVet al 15 and Bajwa BS et al 16 where they found prolonged analgesia in clonidine group as compared to fentanyl group. The increase in duration of post operative analgesia, seen with fentanyl and clonidine in our study, was different from some of the previous studies [3][4][5]13,14 and that may be due to difference in doses of clonidine, fentanyl, or bupivacaine used in our study.…”

Section: Discussionsupporting

confidence: 92%

Comparison of Clonidine and Fentanyl as an Adjuvant to Intrathecal 0.5% Hyperbaric Bupivacaine in Patients Undergoing Knee Arthroplasty

Jethani

Sahu

Bansal

2020

IJMBS

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Background and Objective: Fentanyl and clonidine as adjuvants are commonly mixed with 0.5% bupivacaine heavy, by intrathecal route, for prolonging both sensory and motor blockade as well as for enhancing postoperative analgesia in patients undergoing major abdominal or lower limb surgery. This study was undertaken to compare the intraoperative effects and postoperative analgesia of fentanyl and clonidine, used as adjuvant to intrathecal bupivacaine during knee arthroplasty. Methodology: This prospective, randomized study was conducted on 60 patients of ASA grade I or II, between 20 and 50 years of age divided into two groups of 30 each. The patients were given 3 ml of 0.5% hyperbaric bupivacaine with either 25 mcg of fentanyl (Group F) or 50 mcg of clonidine (Group C) intrathecally. The onset of sensory and motor block, the duration of blockade, hemodynamic parameters, sedation score, total postoperative analgesia time, and side effects if any were recorded. Results: Both the groups were statistically comparable for demographic data, onset of sensory and motor blockade, duration of blockade and hemodynamic parameters. However, the sedation score was more in clonidine group. The duration of analgesia was significantly prolonged in clonidine group when compared with fentanyl group. Conclusion: In comparison to fentanyl, addition of clonidine to intrathecal bupivacaine prolongs the duration of postoperative analgesia and cause a higher sedation score. Key words: Bupivacaine, clonidine, fentanyl

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Section: Discussionsupporting

confidence: 92%

Comparison of Clonidine and Fentanyl as an Adjuvant to Intrathecal 0.5% Hyperbaric Bupivacaine in Patients Undergoing Knee Arthroplasty

Jethani

Sahu

Bansal

2020

IJMBS

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“…Literature is divided regarding efficacy of both intrathecal clonidine and fentanyl in providing prolonged postoperative analgesia. Studies by Khezri et al .,[ 7 ] Bajwa et al .,[ 8 ] Chhabra et al .,[ 9 ] and Sharan et al . [ 10 ] opined that intrathecal clonidine was more potent in providing prolonged analgesia compared to intrathecal fentanyl.…”

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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“…for the persistence of postoperative analgesic time. [16,17] It was also supported by other different studies which gave the evidence of 50 µg clonidine to intrathecal bupivacaine made the lengthening of analgesic duration in comparison to 25 µg fentanyl with bupivacaine [18][19][20].…”

Section: Discussionmentioning

confidence: 72%

Comparison of the postoperative analgesic effects of intrathecal Clonidine and Fentanyl as adjuvant: Mata Analysis of randomized control trials

Tarekegn

Hailekiros

Eshetie

2018

Preprint

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Background: Intrathecal clonidine and fentanyl added to bupivacaine prolongs the postoperative analgesic effects for below umbilicus surgery. However, the overall effect of clonidine and fentanyl mixed with spinal anesthesia is not harmonized. Therefore, the aim of this Meta - analysis was to assess the post operative analgesic effects of intrathecal clonidine and fentanyl for different randomized control trials of study. Methods: Pubmed, Cochrane Review, EMBASE, and Google Scholar were searched and a total of four studies have been selected for Meta – Analysis. Three authors engaged independently to extract data on the efficacy of intrathecal clonidine and fentanyl for lower abdomen and limb surgeries. The statistical analysis was accomplished by RevMan (version 5.3) software. The overall efficacy of intrathecal clonidine and fentanyl were pooled by Forrest plot, table, and figure with 95% confidence interval. Results: The pooled effect size mean difference of intrathecal clonidine versus fentanyl was 83.57(95 % CI, 29.33 to 137.82) minutes. Furthermore, the lowest and highest mean difference of effect size was 10.60 and 175.98 minutes respectively. Conclusion: Intrathecal clonidine as adjuvant to bupivacaine gave the prolonged postoperative analgesia in comparison to intrathecal fentanyl. So it is recommended to use clonidine as intrathecal adjuvant when we consider the extended postoperative analgesia.

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Comparison of intrathecal clonidine and fentanyl in hyperbaric bupivacaine for spinal anesthesia and postoperative analgesia in patients undergoing lower abdominal surgeries

Cited by 17 publications

References 15 publications

Comparison of Clonidine and Fentanyl as an Adjuvant to Intrathecal 0.5% Hyperbaric Bupivacaine in Patients Undergoing Knee Arthroplasty

Comparison of Clonidine and Fentanyl as an Adjuvant to Intrathecal 0.5% Hyperbaric Bupivacaine in Patients Undergoing Knee Arthroplasty

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

Comparison of the postoperative analgesic effects of intrathecal Clonidine and Fentanyl as adjuvant: Mata Analysis of randomized control trials

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