Pre-Emptive Oral Clonidine for Immediate Postoperative Pain in Surgeries Under Sub-Arachnoid Block

Kolarkar, Priti; Badwaik, Gunjan; Watve, Ajay; Agarkar, Sandip; Kalbande, Jitendra; Giri, Anurag; Bhangale, Nupur; Bhalerao, Amol

doi:10.14260/jemds/2014/3572

Cited by 2 publications

(2 citation statements)

References 23 publications

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“…[ 8 ] carried out a randomized, double-blind study in 60 patients to assess the potential beneficial effects of prolongation of spinal analgesia with two different doses of oral clonidine and concluded that clonidine at the dose of 0.15 mg and 0.3 mg increases the duration of spinal anesthesia in comparison to the placebo, but 0.3 mg caused more hemodynamic changes compared with 0.15 mg. Kolarkar et al . [ 9 ] evaluated postoperative analgesic benefit in patients administered clonidine (150 μg) or placebo for below umbilical surgeries to be performed under the SAB using 3 mL 0.5% bupivacaine and to compare their postoperative efficacy with respect to duration of analgesia and concluded that clonidine group had more sedation throughout the postoperative period than in the control group and that it proved to have a better analgesic effect, reducing the total consumption of postoperative analgesia and prolonging first rescue analgesic dose. Gupta et al .,[ 10 ] in a prospective study, evaluated the efficacy of preemptive analgesia of oral clonidine for gynecological procedures under the SAB and concluded that it enhanced the onset of spinal anesthesia, prolonged the duration of analgesia, and provided clinically effective sedation without any respiratory depression.…”

Section: Discussionmentioning

confidence: 99%

Comparison of oral versus intramuscular clonidine for the prolongation of bupivacaine spinal anesthesia in patients undergoing lower abdominal and lower limb surgeries

Shekhar

Singh

et al. 2022

Anesth Essays Res

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Background: Spinal subarachnoid block (SAB) is the first choice anesthesia in lower abdominal and lower limb surgeries. It produces a varying degree of sensory analgesia, motor blockade, and sympathetic blockade depending on the dose, concentration, and volume of the local anesthetic given. This study was undertaken to assess the degree of sensory and motor block with 150 μg of oral versus intramuscular clonidine as an adjuvant to bupivacaine for spinal anesthesia. Aims and Objective: To compare the efficacy of oral versus intramuscular clonidine as an adjuvant to bupivacaine for the prolongation of sensory and motor block in patients undergoing lower abdominal and lower limb surgeries under SAB. Materials and Methods: After institutional ethical clearance, 90 patients were randomized into three groups scheduled for lower abdominal and lower limb surgeries under spinal anesthesia. • Group O: Bupivacaine 0.5% (heavy) 3.0 mL and oral clonidine 150 μg 1 h before spinal anesthesia. • Group I: Bupivacaine 0.5% (heavy) 3.0 mL and intramuscular clonidine 150 μg 1 h before spinal anesthesia. • Group C: Control group – 3 mL bupivacaine 0.5% (heavy) alone. Result: The onset of sensory block in Group O was 4.9 ± 0.52 min, whereas in Group I, it was 4.6 ± 0.42 min than Group C (5.1 ± 0.60). Onset of motor block was also significantly lower in Group O and Group I (3.9 ± 0.53 and 3.7 ± 0.42 min) than in Group C (4.4 ± 0.6 min) which was a control group. There was also a significant difference in the duration of the sensory block between Group O (206.4 ± 9.2 min), Group I (219 ± 8.6 min), and Group C (184.3 ± 9.1 min). The duration of motor block was significantly higher in Group O (183.6 ± 8.2 min) and Group I (197.8 ± 9.6 min) when compared to Group C (162.8 ± 8.9 min). The timing of rescue analgesia in Group O was 222.4 ± 11.7 min, whereas in Group I, it was 243.46 ± 10.9. Conclusion: On the basis of finding of our study, we conclude that the use of clonidine as a premedication at a dose of 150 μg significantly increased the duration of sensory block, motor block, and duration of analgesia and shortened the time of onset of sensory and motor blockade.

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Section: Discussionmentioning

confidence: 99%

Comparison of oral versus intramuscular clonidine for the prolongation of bupivacaine spinal anesthesia in patients undergoing lower abdominal and lower limb surgeries

Shekhar

Singh

et al. 2022

Anesth Essays Res

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“…The purpose of preemptive analgesia is to reduce pain caused due to surgical incision triggered inflammatory mechanism activation; and to ensure a good post-operative pain control so that there is no development of chronic pain. 3 The concept of preemptive analgesia has now become popular and some drugs such as opioid, local anesthetics, and nonsteroidal anti-inflammatory drugs have been demonstrated for their preemptive effect in previous studies. 4 Various modalities have been tried but sideeffects produced by them limits their use.…”

Section: Introductionmentioning

confidence: 99%

A randomized clinical study to compare pre-emptive analgesic efficacy of clonidine and diclofenac sodium in patients undergoing major surgeries at a tertiary care hospital

Jain

Bhosale²,

Desai

2020

Int J Basic Clin Pharmacol

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Background: Pre-emptive analgesia is a method to achieve analgesia even before exposure to a noxious stimulus The purpose of pre-emptive analgesia is to reduce pain caused due to surgical incision triggered inflammatory mechanism activation; and to ensure a good post-operative pain control so that there is no development of chronic pain. Clonidine is an α2 adrenergic agonist thus it decreases the sympathetic outflow, while Diclofenac is a non-steroidal anti-inflammatory agent. Our literature review showed that both clonidine (150 μg) and diclofenac are efficacious pre-emptive analgesics. Literature review also revealed that there is no study available to compare pre-emptive analgesic efficacy as well as safety of oral clonidine with diclofenac, therefore present study was designed to compare pre emptive analgesic efficacy of these two drugs.Methods: This randomized clinical study included 100 patients from surgical departments, of either sex, between 18 to 70 years age and of American society of anesthesiologists (ASA) I/II grade. Patients were randomly allocated to two groups and received either of the treatments 30 minutes prior to induction of anesthesia. Pain scores were recorded using visual analog scale, facial rating scale and behavioral rating scale at awakening and at 1, 2, 4, 6 and 24 hours. Postoperative analgesic requirement over 24 hours was recorded. Data were analyzed using OpenEpi statistical softwares.Results: Significantly lower pain scores were observed in clonidine group as compared to Diclofenac at 4 and 6 hours (p<0.05) on all the pain scales. Clonidine group also required less postoperative analgesic as compared to diclofenac (p<0.05).Conclusions: Study results are strongly suggestive of greater pre-emptive analgesic efficacy of clonidine over diclofenac in major surgeries done under spinal anesthesia.

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Pre-Emptive Oral Clonidine for Immediate Postoperative Pain in Surgeries Under Sub-Arachnoid Block

Cited by 2 publications

References 23 publications

Comparison of oral versus intramuscular clonidine for the prolongation of bupivacaine spinal anesthesia in patients undergoing lower abdominal and lower limb surgeries

Comparison of oral versus intramuscular clonidine for the prolongation of bupivacaine spinal anesthesia in patients undergoing lower abdominal and lower limb surgeries

A randomized clinical study to compare pre-emptive analgesic efficacy of clonidine and diclofenac sodium in patients undergoing major surgeries at a tertiary care hospital

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