Subarachnoid clonidine or fentanyl with low dose hyperbaric bupivacaine for elective caesarean section - A comparative study

Islam, Mohammad S.; Ali, Nadeem Parvez; Begum, Rabeya; Akhtaruzzaman, Akm

doi:10.3329/jdnmch.v17i1.12185

Cited by 4 publications

(9 citation statements)

References 15 publications

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“…Similarly in the study conducted by Islam et al .,[ 9 ] the incidence of side effects such as nausea/vomiting, chest pain, and shivering were lesser in the group which received reduced amount of bupivacaine (1.75 ml) with clonidine (75 mcg) as adjuvant. Kothari et al .…”

Section: Discussionmentioning

confidence: 99%

Clinical study to determine the efficacy of clonidine as an adjuvant to intrathecal bupivacaine in patients undergoing cesarean section

et al. 2017

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Introduction:Spinal anesthesia with bupivacaine is associated with hypotension and inadequate postoperative analgesia. The addition of clonidine as an adjuvant to intrathecal bupivacaine is beneficial in reducing the dose of the local anesthetic and also provides prolonged postoperative analgesia.Methodology:One hundred and five American Society of Anesthesiologists physical status Classes 1 and 2 parturient women undergoing elective cesarean section were randomly divided into three groups. Patients in Group C (control) received 2 ml of 0.5% of heavy bupivacaine (10 mg) with 0.5 ml of 0.9% saline to a total volume of 2.5 ml, those in Group H (high dose of bupivacaine) received 2 ml of 0.5% of heavy bupivacaine (10 mg) with 1 μg/kg of clonidine and 0.9% saline to make a total volume of 2.5 ml, and those in Group L (low dose of bupivacaine) received 1.5 ml of 0.5% of heavy bupivacaine (7.5 mg) with 1 μg/kg clonidine and 0.9% saline to make a total volume of 2.5 ml. Patients were observed for onset and duration of sensory and motor block and for postoperative analgesia.Results:Patients who received clonidine as adjuvant had effective prolonged postoperative analgesia (Group H – 480 ± 40 min, Group L – 480 ± 34 min) as compared to control group (180 ± 19 min).Conclusion:The dose of intrathecal bupivacaine 0.5% was effectively reduced to 7.5 mg by adding 1 μg/kg of clonidine as adjuvant in patients undergoing elective cesarean section.

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Section: Discussionmentioning

confidence: 99%

Clinical study to determine the efficacy of clonidine as an adjuvant to intrathecal bupivacaine in patients undergoing cesarean section

et al. 2017

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“…compared the complications, quality of anesthesia, and duration of postoperative analgesia with the use of adjuvant clonidine 75 µg or fentanyl 25 µg with hyperbaric bupivacaine in SAB for cesarean section. [ 14 ] The study revealed that subarachnoid clonidine and fentanyl, as adjuvant with low-dose hyperbaric bupivacaine, provides better quality of block, better quality of anesthesia, more hemodynamic stability, and longer duration of postoperative analgesia, compared to bupivacaine alone. It is also revealed that clonidine is a better alternative to fentanyl as an adjuvant with bupivacaine in SAB.…”

Section: Discussionmentioning

confidence: 99%

A comparative study on effect of addition of clonidine and fentanyl as adjuvants to local anaesthetics for subarachnoid block in patients undergoing lumbar laminectomies

et al. 2016

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Background:The synergism between local anesthetic agents such as bupivacaine with intrathecal adjuvants such as opioids and clonidine is well established.Aims:This study evaluates the clinical efficacy of clonidine75 μg versus fentanyl 25 μg as adjuvants to bupivacaine for spinal anesthesia.Settings and Design:A prospective, randomized, parallel arm study was conducted over a period of 12 months in a tertiary care hospital.Materials and Methods:Sixty patients were divided randomly into two groups, Group C and Group F. Patients in Group C received 2.5 ml of 0.5% bupivacaine heavy mixed with 0.5 ml (75 μg) clonidine intrathecally, and patients in Group F received 2.5 ml of 0.5% bupivacaine heavy mixed with 0.5 ml (25 μg) fentanyl intrathecally.Statistical Analysis:Data were analyzed using statistical tests for comparison of means.Results:The mean durations of sensory block was 253.3 and 249.6 minutes in group C and group F respectively, which was statistically not significant (P = 0.76). The mean durations of motor block were 302.3 and 293.6 min, respectively, in Group C and Group F, which were also statistically not significant (P = 0.53). The mean durations of postoperative analgesia were 653.4 and 611.2 min, respectively, in Group C and Group F, which were statistically not significant (P = 0.09). Mean heart rate after 10 min was 82.5 in Group C and 87.2 in Group F, which was statistically not significant (P = 0.29), and mean arterial pressure in mmHg after 10 min was 96.3 in Group C and 97.3 in Group F, which was also statistically not significant (P = 0.86).Conclusion:Both clonidine 75 μg and fentanyl 25 μg when used as adjuvants to bupivacaine in the subarachnoid block have comparable beneficial results in terms of duration of analgesia, duration of motor blocks, and hemodynamic stability and also have a comparable incidence of complications.

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“…Ringer's lactate solution was most commonly used for preloading, in the range of 500–1500 ml. Hypotension was managed with ephedrine as a sole drug in five studies[15679] and mephentermine was used in one study. [3] Bradycardia (defined as a heart rate <45–50 min/min) was managed with IV atropine in three studies.…”

Section: Qualitative Data Synthesismentioning

confidence: 99%

“…[1234] However, hypotension during spinal anesthesia for cesarean section is the most common complication associated with nausea and vomiting, altered mental status and risk of aspiration. [1456789]…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of low dose bupivacaine with intrathecal fentanyl for cesarean section on maternal hemodynamic: Systemic review and meta-analysis

Abate

Belihu

2019

Saudi J Anaesth

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Hypotension during spinal Anesthesia is the most common complication with maternal and neonatal morbidity and mortality. Low dose bupivacaine with intrathecal fentanyl is recommended as strategy to prevent spinal Anesthesia induced hypotension and related complications. The aim of this systemic review is to evaluate the efficacy of low dose bupivacaine with Intrathecal fentanyl on the improvement of maternal and neonatal outcomes compared to conventional dose bupivacaine among mothers who undergone cesarean section. We conducted a systemic search of the electronic databases of Pubmed, Medline, LILACS and others with PICO strategy for randomized controlled clinical trials comparing low dose bupivacaine with fentanyl and conventional dose bupivacaine for cesarean section. Joanna Briggs Institute (JBI) standardized data extraction form was used for data extraction and finally entered into Review Manager for data synthesis. Ten Randomized trials (552) were included in this review. Incidence of hypotension was less likely in mothers who received low dose bupivacaine with Fentanyl as compared to those with conventional dose of bupivacaine alone (RR = 0.43, 95% confidence interval (CI) 0.12-0.47, ten trials, 552 participants). The review revealed that Low dose bupivacaine combined with intrathecal Fentanyl decrease incidence of hypotension.

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Subarachnoid clonidine or fentanyl with low dose hyperbaric bupivacaine for elective caesarean section - A comparative study

Cited by 4 publications

References 15 publications

Clinical study to determine the efficacy of clonidine as an adjuvant to intrathecal bupivacaine in patients undergoing cesarean section

Clinical study to determine the efficacy of clonidine as an adjuvant to intrathecal bupivacaine in patients undergoing cesarean section

A comparative study on effect of addition of clonidine and fentanyl as adjuvants to local anaesthetics for subarachnoid block in patients undergoing lumbar laminectomies

Efficacy of low dose bupivacaine with intrathecal fentanyl for cesarean section on maternal hemodynamic: Systemic review and meta-analysis

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