A COMPARATIVE STUDY OF EFFECTS OF INTRATHECAL 4.0 CC OF 0.75% ISOBARIC ROPIVACAINE AND 3.5 CC OF 0.50% ISOBARIC ROPIVACAINE WITH 30 MCG CLONIDINE PLUS 0.3 CC OF STERILE NORMAL SALINE IN BENIGN PROSTATE HYPERPLASIA PATIENTS UNDERGOING TRANS URETHERAL RESECTION OF PROSTATE
Abstract
Introduction: Spinal anaesthesia is a popular and common technique used worldwide. A newly introduced long acting amide linked local anaesthetic called `ROPIVACAINE, produces less motor blockade and is of shorter duration than bupivacaine. Intrathecal clonidine is being extensively evaluated as an alternative to neuraxial opoids for control of pain and has proven to be a potent analgesic. A very important advantage of ropivacaine over bupivacaine is less cardiovascular toxicity.
Aims and objectives: present study was planned to investigate the effects, ( onset of action, duration of action, quality of sensory and motor block, haemodyamic stability and post-operative analgesia ) of intrathecal 4.0 cc of 0.75% isobaric ropivacaine and 3.5 cc of 0.50% isobaric ropivacaine with 30 mcg clonidine plus 0.3 cc of sterile normal saline in benign prostate hyperplasia patients undergoing trans uretheral resection of prostate.
Materials and methods: this Prospective, randomized, double blind, comparative study was conducted at the Department of anaesthesiology and Critical Care, Government Medical College and Associated Group of Hospitals, Kota in patients posted for elective trans urethral resection of prostate with benign prostate hyperplasia. We made two groups of cases i.e. Group R (ROPIVACAINE) and Group RC (ROPIVACAINE WITH CLONIDINE). sample size was 80, which was divided into two groups of 40 each. Standard protocol followed to administering spinal anaesthesia. All data were collected and analysed with the help of suitable statistical parameters.
Results: Our study results in that combination of clonidine (30 mcg) as an adjuvant with 0.50% isobaric ropivacaine (17.5 mg) in subarachanoid blockade for trans urethral resection of prostate results in prolonged duration of sensory blockade and extended postoperative analgesia compared to plain 0.75% isobaric ropivacaine (30 mg).
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Rauck RL, Eisenach JC, Jackson K, et al. Epidural clonidine for refractory reflex sympathetic distrophy. Anesthesiology 1991; 75: 657-8.
Paul GB, Bruce FC. Clinical Anesthesia, Lippincort,Williams and Wilkins. 2006;6:700-706.
Gustafsson LL, Schildt B, Jackobson K. Adverse effects of extra dural and intra thecal opiates: report of a nationwide survey in Sweden.Br J Anaesth.1982; 54:479-86.
Eisenach JC. Overview; First international symposium on α-2 adrenergic mechanisms of spinal anaesthesia. RegAnaesth.1993;18(4):1-6.
Acalovschi I, Bodolea C, Manoiu C: Spinal anesthesia with meperidine.Effects of added alpha-adrenergic agonists: Epinephrine versus clonidine. Anesth Analg 1997; 84:1333–9.
Dobrydnjov I, Samarutel J: Enhancement of intrathecal lidocaine by additionof local and systemic clonidine. Acta Anaesth Scand 1999; 43:556–62.
Dobrydnjov I, Axelsson K, Samarutel J,Holmstrom B. Postoperative pain relief following intrathecal bupicaine combined with intrathecal or oral clonidine. Acta AnaesthesiolScand.2002;46:806-14/
Park J, Forrest J, Kolesar R. Oral clonidine reduces postoperative PCA morphine requirements. Can JAnaesth.1996;43:900-6.
Duggal R, Kapoor R, Moyal G. A comparison of intrathecal levobupivacaine with hyperbaric bupivacaine for elective cesarean section: A prospective randomized double-blind study. J Obstet Anaesth Crit Care, 2015; 5: 78-83.
Savarese J, Covino B. Basic and clinical pharmacology of local anesthetic drugs. In: Anesthesia, Miller RD. New York: Churchill Livingston, New York, Edinburgh, London,Melbourne.1986;2(2):986–7,985-1013.
Ruetsch YA, Böni T, Borgeat A. From cocaine to ropivacaine: The history of local anesthetic drugs. Curr Top Med Chem 2001;1:175-82.
Akerman B, Hellberg B, Trossvik C, Primary evaluation of the local anaesthetic property of the amino amid agent robivacine. Acta Anaesthesiol Scand 1988;32:571-8.
Brockway MS, Bannister J, Mc Clure JH , et al . Comparison of extradural robivacaine and bupivacaine. Br J anaesth 1991;66:31-7.
Scott, Lee A, Fagan D. Acute toxicity of ropivacaine compared with that of bupivacaine. AnesthAnalg.1995;69:563–9.
Markham F. Ropivacaine a review of its pharmacology and therapeutic use in regional anaesthesia. Br JAnesth.1996;76:300-307.
Ögün C, Kirgiz E, Duman A, Kara I, Ökesli S. The comparison of intrathecal isobaric ropivacaine and isobaric ropivacaine-clonidine for caesarean delivery. The Internet Journal ofAnesthesiology.2006;15(1).
Kleef VJ, Veering B, Burm A. Spinal Anesthesia with ropivacaine a double blind study on the efficacy and safety of 0.5% and 0.75% solutions in patients undergoing minor lower limb surgery. AnesthAnalg.1994;78:1125-30.
Kock D. Intrathecal ropivacaine and clonidine for ambulatory knee arthroscopy, a dose responsestudy.Anesthesiology.2001;94:574-8.
Shah Z, Kundal R, Gupta A, Malla M, Zahoor F, Kundal V et al. Efficacy of analgesic effect of low dose intrathecal clonidine as adjuvant to bupivacaine in urogenital surgeries study in a kashmiri population. Sri Lankan Journal of Anaesthesiology.2012;20(1):49-52.
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