INTRATHECAL CLONIDINE WITH LEVOBUPIVACAINE FOR TRANSURETHRAL RESECTION OF PROSTATE: A RANDOMISED CONTROLLED TRIAL

Arora Sakshi, Sabharwal Bhavnish

Abstract


We studied the effects of intrathecal clonidine added to isobaric levobupivacaine for anesthesia & analgesia in transuretheral resection of prostate (TURP) surgery and observed there side effects. In this randomized, prospective, controlled trial, two groups of 50 patients were studied as (i) Patients in Group A received 15 mg (3ml) of 0.5% isobaric levobupivacaine and 0.30ml of 0.9% normal saline and (ii) Patients in Group B received 15 mg (3ml) of 0.5% isobaric levobupivacaine and 0.30ml (50µg) of clonidine. The duration of analgesia, variation in motor block, hemodynamic variations, any associated side effects due to intrathecal clonidine were recorded. It was observed that addition of small dose of clonidine to isobaric levobupivacaine given intrathecal resulted in faster onset, longer duration of analgesia & prolongation of motor blockade & there side effects (hypotension) were treatable. The finding suggests that clonidine added to isobaric levobupivacaine is an attractive option for improving the quality and duration of analgesia for treating pain and discomfort to the patient in transuretheral resection of prostate surgery.


Keywords


Analgesia, Isobaric levobupivacaine, Intrathecal Clonidine, TURP

Full Text:

PDF

References


Strebel S, Gurzeler JA, Schneider MC, Aeschbach A, Kindler CH. Small-dose intrathecal clonidine and isobaric bupivacaine for orthopedic surgery: a dose-response-study. Anesth Analg. 2004;99:1231–38. [PubMed] [Google Scholar]

Kanazi GE, Aouad MT, Jabbour-Khoury SI, Al Jazzar MD, Alameddine MM, Al-Yaman R, et al. Effect of low-dose dexmedetomidine or clonidine on the characteristics of bupivacaine spinal block. Acta Anaesth Scand. 2006;50:222–7. [PubMed] [Google Scholar]

Foster RH, Markham A. Levobupivacaine: A Review of its pharmacology and use as a local anaesthetic. Drugs. 2000;59:531–79. [PubMed] [Google Scholar]

Eisenach JC, De Kock M, Klimscha W. α2-Adrenergic Agonists for Regional Anesthesia: A Clinical Review of Clonidine (1984 - 1995) Anesthesiology. 1996;85:655–74. [PubMed] [Google Scholar]

Harada Y, Nishioka K, Kitahata LM, Kishikawa K, Collins JG. Visceral antinociceptive effects of spinal clonidine combined with morphine, enkephalin, or U50, 488H. Anesthesiology. 1995;83:344–52. [PubMed] [Google Scholar]

Al-Ghanem SM, Massad IM, Al-Mustafa MM, Al-Zaben KR, Qudaisat IY, Qatawneh AM, Abu-Ali HM. Effect of Adding Dexmedetomidine versus Fentanyl to Intrathecal Bupivacaine on Spinal Block Characteristics in Gynecological Procedures: A Double Blind Controlled Study. Am J Appl Sci. 2009;6:882–7. [Google Scholar]

Gabriel JS, Gordin V. Alpha 2 agonists in regional anesthesia and analgesia. Curr Opin Anaesthesiol. 2001 Dec;14(6):751-3.

Huang YF, Pryor ME, Mather LE, Veering BT. Cardiovascular and central nervous system effects of intravenous levobupivacaine and bupivacaine in sheep. Anesth Analg. 1998;86:797–804. [PubMed] [Google Scholar]

Burm AG, van der Meer AD, van Kleef JW, Zeijlmans PW, Groen K. Pharmacokinetics of the enantiomers of bupivacaine following intravenous administration of the racemate. Br J Clin Pharmacol. 1994;38:125–9. [PMC free article] [PubMed] [Google Scholar]

Burlacu CL, Buggy DJ. Update on local anesthetics: Focus on levobupivacaine. Ther Clin Risk Manag. 2008;4:381–92. [PMC free article] [PubMed] [Google Scholar]

Milligan KR1, Convery PN, Weir P, Quinn P, Connolly D.The efficacy and safety of epidural infusions of levobupivacaine with and without clonidine for postoperative pain relief in patients undergoing total hip replacement. Anesth Analg. 2000 Aug;91(2):393-7.

Bazin M1, Bonnin M, Storme B, Bolandard F, Vernis L, Lavergne B, Pereira B, Bazin JE, Dualé C. Addition of clonidine to a continuous patient-controlled epidural infusion of low-concentration levobupivacaine plus sufentanil in primiparous women during labour. The Association of Anaesthetists of Great Britain and Ireland. Anaesthesia. 2011 Sep;66(9):769-79. PMID: 21707560.

Aliye Esmaoğlu,1 Sümeyra Türk,2 Adnan Bayram,1 Aynur Akın,1 Fatih Uğur,1 and Ayşe Ülgey1. The Effects of Dexmedetomidine Added to Spinal Levobupivacaine for Transurethral Endoscopic Surgery. Balkan Med J. 2013 Jun; 30(2): 186–190. PMID: 25207098

Santiveri X, Arxer A, Plaja I, Metje MT, Martínez B, Villalonga A, et al. Anaesthetic and postoperative analgesic effects of spinal clonidine as an additive to prilocaine in the transurethral resection of urinary bladder tumours. Eur J Anaesth. 2002;19:589–93. [PubMed] [Google Scholar]


Refbacks

  • There are currently no refbacks.