Addition of clonidine reduce dose of fentanyl and Ropivacaine in Epidural Anaesthesia

Aim of Study: To find out effect of clonidine on fentanyl and Ropivacaine requirement to produce Epidural Anesthesia. Material and Method: After Institute ethical clearance and consent from patient, 60 patients of ASA I and II were studied in 3 groups. All patients were premedicated with ranitidine and metoclopramide. In operation room epidural catheter was placed. After recording base line hemodynamic parameters, drugs were mixed in 20ml syringe according to 3 different groups and given through epidural catheter. Observation and Result: All patients were monitored for hemodynamic changes and recorded at different time interval. Data were analyzed using different tests. Patients of all 3 group have similar level of anesthesia with lower adverse effects hypotension which was more in clonidine, fentanyl and ropivacaine group. Conclusion: With this study we concluded that adition of clonidine in fentanyl and ropivacaine significantly reduces the amount of ropivacaine and fentanyl required to produce epidural anesthesia.

[1]  K. Malhotra,et al.  Postoperative analgesia in children when using clonidine or fentanyl with ropivacaine given caudally , 2011, Journal of anaesthesiology, clinical pharmacology.

[2]  S. Bajwa,et al.  Comparison of epidural ropivacaine and ropivacaine clonidine combination for elective cesarean sections , 2010, Saudi journal of anaesthesia.

[3]  M. Beach,et al.  Intrathecal Clonidine Added to a Bupivacaine-Morphine Spinal Anesthetic Improves Postoperative Analgesia for Total Knee Arthroplasty , 2003, Anesthesia and analgesia.

[4]  L. Gurrin,et al.  A Randomized, Double-Blinded Trial of Subarachnoid Bupivacaine and Fentanyl, With or Without Clonidine, for Combined Spinal/Epidural Analgesia During Labor , 2002, Anesthesia and analgesia.

[5]  R. Landau,et al.  The Dose-Sparing Effect of Clonidine Added to Ropivacaine for Labor Epidural Analgesia , 2002, Anesthesia and analgesia.

[6]  D. Scott,et al.  A Comparison of Epidural Ropivacaine Infusion Alone and with Three Different Concentrations of Fentanyl for 72 Hours of Postoperative Analgesia Following Major Abdominal Surgery. , 1998, Regional Anesthesia & Pain Medicine.

[7]  J. Eisenach,et al.  Alpha sub 2 -Adrenergic Agonists for Regional Anesthesia: A Clinical Review of Clonidine (1984 - 1995) , 1996, Anesthesiology.

[8]  H. Bunting,et al.  Postoperative Analgesia After Co-administration of Clonidine and Morphine by the Intrathecal Route in Patients Undergoing Hip Replacement , 1995, Anesthesia and analgesia.

[9]  H. Kehlet,et al.  Epidural clonidine enhances postoperative analgesia from a combined low-dose epidural bupivacaine and morphine regimen. , 1992, Anesthesia and analgesia.

[10]  M. Finster,et al.  Systemic toxicity of ropivacaine during ovine pregnancy. , 1991, Anesthesiology.

[11]  K. Ludwig,et al.  Addition of clonidine enhances postoperative analgesia from epidural morphine: a double-blind study. , 1990, Anesthesiology.

[12]  D. Denson,et al.  Pharmacodynamics and Pharmacokinetics of Epidural Ropivacaine in Humans , 1990, Anesthesia and analgesia.

[13]  L. Kitahata,et al.  Intrathecal Clonidine Suppresses Noxiously Evoked Activity of Spinal Wide Dynamic Range Neurons in Cats , 1989, Anesthesia and analgesia.

[14]  L. Mather,et al.  Intrathecal and epidural administration of opioids. , 1984, Anesthesiology.

[15]  H. L. Rogers Continuous caudal anesthesia. , 1946, Journal of the Medical Association of the State of Alabama.