Use of Clonidine as an Adjuvant to Infiltration Anaesthesia in Tympanoplasty: A Randomized Double Blind Study

Raghuwanshi, Shiv Kumar; Chakravarty, Nupur; Asati, Dinesh P; Bankwar, Vishal

doi:10.1007/s12070-013-0664-4

Cited by 9 publications

(5 citation statements)

References 17 publications

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“…The authors observed that patients receiving fentanyl 100 μg had lower VAS score as compared to patients requiring fentanyl 50 μg at 4 and 6 h postoperatively. Raghuwanshi et al [ 18 ] reported improved pain scores in the first 6 h post-block in patients receiving 12 mL of 2% lignocaine with adrenaline and 30 μg of clonidine during infiltrative block given by the surgeon in chronic suppurative otitis media. In another study, higher tramadol consumption was reported in patients receiving GAN block with 5 mL of 0.25% bupivacaine versus ultrasound-guided SCPB with 10 mL of 0.25% bupivacaine.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of analgesic efficacy of superficial cervical plexus block in patients undergoing modified radical mastoidectomy: A randomised controlled trial

Ahuja¹,

Deepika²,

Thapa³

et al. 2021

Indian J Anaesth

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Background and Aims: Intravenous analgesics and local infiltration are used for postoperative analgesia in patients undergoing mastoidectomy. No randomised controlled trial (RCT) has so far determined response rates of pain reduction after ultrasound-guided superficial cervical plexus block (SCPB) in adult patients undergoing modified radical mastoidectomy. Methods: This double-blind RCT was conducted in 30 adult patients of the American Society of Anesthesiologists (ASA) grade I/II undergoing modified radical mastoidectomy. The primary outcome was a reduction in the visual analogue scale (VAS) score. Secondary outcomes were postoperative diclofenac consumption, haemodynamics, and occurrence of any adverse events. All patients received general anaesthesia. At the end of the surgery, patients were randomised to either Group ‘Block’ ( n = 15) ultrasound guided SCPB with 5 mL ropivacaine 0.5% or Group ‘No block’ ( n = 15). All patients received intravenous (IV) paracetamol 1 g every 6 hourly and rescue analgesic IV diclofenac 75 mg if VAS score >4. Results: Patients in Group ‘Block’ reported lower VAS score at rest versus Group ‘No block’ at 1 h postoperatively ( P = 0.012). VAS score on movement was lower in patients of Group ‘Block’ compared to Group ‘No block’ at 1 h ( P = 0.010), 4 h ( P = 0.035), 8 h ( P = 0.027), and 12 h (* P = 0.003) postoperatively. Diclofenac consumption was lower in patients of Group ‘Block’ ( P = 0.041). No adverse effects were reported. Conclusion: Postoperative ultrasound-guided SCPB produced higher response rates in terms of reduction in VAS score in patients undergoing modified radical mastoidectomy.

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Section: Discussionmentioning

confidence: 99%

Evaluation of analgesic efficacy of superficial cervical plexus block in patients undergoing modified radical mastoidectomy: A randomised controlled trial

Ahuja¹,

Deepika²,

Thapa³

et al. 2021

Indian J Anaesth

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“…A study found that 30 μg clonidine added to lidocaine 2% in tympanoplasty had a significant impact in decreasing the bleeding in the operative field and improving the quality of intraoperative anesthesia as well as prolonging the duration of postoperative analgesia without significant side effects 19 …”

Section: Discussionmentioning

confidence: 99%

“…18 A study found that 30 μg clonidine added to lidocaine 2% in tympanoplasty had a significant impact in decreasing the bleeding in the operative field and improving the quality of intraoperative anesthesia as well as prolonging the duration of postoperative analgesia without significant side effects. 19 Thus, there are adequate data over the years supporting the use f. Clonidine induces bradycardia, hypotension and also has antiarrhythmic effect. Thus, it effectively counteracts tachycardia induced by epinephrine in tumescent fluid/anesthetic fluid.…”

Section: Discussionmentioning

confidence: 99%

Oral clonidine as a pre‐anesthetic medication in hair transplantation surgery—A pilot study

Mysore¹,

Muniswamy²,

Chathra³

et al. 2022

J of Cosmetic Dermatology

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Background Hair transplantation (HT) is a safe and rewarding procedure for a patient as well as the surgeon. Clonidine may be a good adjuvant in HT because of its analgesic, anxiolytic, and sedative effects. Objective To study efficacy of Clonidine as a preoperative medication in HT. Methods & Materials The study was a prospective trial of 46 consecutive patients who underwent HT between January and May 2017. Patients with normal vital parameters on arrival were given Tab clonidine (0.1 mg) 30 min before starting of the procedure [Clonidine group (n = 30)]; rest were included in the control group (n = 16). Vitals were monitored every 30 min during surgery until the end. Patients were assessed for pain, level of sedation during surgery and for postoperative analgesia. Result All patients who received clonidine, except one, were comfortable and experienced no pain throughout the duration of surgery; nine went into deep sleep. Of the 16 patients in the control group, no patients reported deep sleep, 3 felt restless, and 4 had mild pain. There were no untoward effects in both groups. Conclusion Our study suggests that clonidine is useful as a pre‐anesthetic medication in HT. However, this is a pilot study and further larger studies are needed.

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“…Clonidine, alpha 2 adrenoreceptor agonist, has been very commonly used as an adjuvant with LA for epidural anesthesia,[ 8 9 ] peripheral nerve blocks,[ 6 10 ] abdominal plane block,[ 11 12 ] and local infiltration. [ 13 ] Clonidine acts by binding to presynaptic C fiber and post synaptic dorsal horn neurons and shows analgesics action by depressing the release of c-fibers, transmitter, and hyperpolarizing post synaptic dorsal horn; thus, significantly prolonging the sensory and motor block. Amongst abdominal plane blocks, clonidine as an adjuvant in transversus abdominis plane (TAP) block has been found to have better postoperative analgesia in patients undergoing cesarean delivery.…”

Section: Discussionmentioning

confidence: 99%

Analgesic efficacy of Clonidine as an adjuvant in ultrasound-guided rectus sheath block for midline incisional hernia repair – A randomized double-blind controlled trial

Chilkoti

Maurya

Mohta

et al. 2022

Journal of Anaesthesiology Clinical Pharmacology

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Background and Aims: Clonidine as an adjuvant has not been evaluated in rectus sheath block (RSB) for postoperative pain management in incisional hernia repair. The study aims to evaluate clonidine as an adjuvant in single-shot RSB along with general anesthesia (GA). Material and Methods: This randomized, double-blind controlled study was conducted following IEC-Human approval and written informed consent from 30 patients of either sex, aged 16 to 60 years, ASA physical status I or II undergoing midline incisional hernia repair under GA. All patients received ultrasound-guided bilateral RSB following administration of GA. The subjects enrolled in the study were randomly allocated to receive either normal saline 1 mL (group B) or clonidine 1 μg/kg diluted to 1 mL with normal saline (group BC) as adjuvant along with 9 mL bupivacaine hydrochloride 0.25%. Inj. tramadol 1 mg/kg was administered for rescue analgesia. The primary outcome was the time to first request for analgesia, and secondary outcomes were total consumption of rescue analgesic over 24 h, numerical rating score (NRS), patients’ satisfaction, hemodynamics, and side effects. Unpaired t-test and Chi-square test were used. Results: On intergroup analysis, the mean time to first request for analgesia (in min) was significantly higher in group BC i.e., [9.60 (± 5.23) vs 5.33 (± 3.53); ( P < 0.034]; whereas, the mean rescue analgesic consumption in 24 h (in mg) was higher in group B i.e., [(88.00 ± 60.97) vs (46.00 ± 48.08)]; ( P < 0.045)]. Hemodynamic parameters i.e., mean blood pressure and heart rate were comparable between the two groups, and there were no side effects. Conclusion: Clonidine as an adjuvant in single-shot ultasonography (USG)-guided RSB along with GA is efficacious for postoperative pain management following midline incisional hernia repair.

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Use of Clonidine as an Adjuvant to Infiltration Anaesthesia in Tympanoplasty: A Randomized Double Blind Study

Cited by 9 publications

References 17 publications

Evaluation of analgesic efficacy of superficial cervical plexus block in patients undergoing modified radical mastoidectomy: A randomised controlled trial

Evaluation of analgesic efficacy of superficial cervical plexus block in patients undergoing modified radical mastoidectomy: A randomised controlled trial

Oral clonidine as a pre‐anesthetic medication in hair transplantation surgery—A pilot study

Analgesic efficacy of Clonidine as an adjuvant in ultrasound-guided rectus sheath block for midline incisional hernia repair – A randomized double-blind controlled trial

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